State of Wyoming settles with Campbell County Health over Medicaid billing audit - Casper, WY Oil City News
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State of Wyoming settles with Campbell County Health over Medicaid billing audit

The Wyoming State Capitol lit up at night during the 2020 session. (Mike Vanata/WyoFile)

CASPER, Wyo. — Wyoming Attorney General Bridget Hill announced Friday that the Campbell County Hospital District has entered into a civil settlement in which the district agreed to pay $1,500,000 to resolve claims that the Children’s Summer Program violated the Wyoming Medicaid False Claims Act. 

The Children’s Summer Program was offered by the Hospital’s Behavioral Health Services Kid’s Clinic as a treatment option for children and families in Campbell County.

According to the AG’s release, an audit conducted by the Attorney General’s Medicaid Fraud Control Unit identified concerns with the program’s documentation and staffing oversight. 

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“The Unit also identified concerns that the Children’s Summer Program billed Wyoming Medicaid for activities that are not covered by Medicaid services,” the release said.

By submitting these bills, the State claims the Hospital District received payments it was not entitled to. 

To resolve the State’s concerns, Campbell County Hospital District agreed to pay $1,500,000, which would cover the program’s Medicaid claims from 2015 through 2019. 

The Hospital District has also agreed to enter into a three-year corporate integrity agreement with the Attorney General’s Medicaid Fraud Control Unit, the release said. The agreement is designed to ensure future claims comply with state health care program requirements. 

The State acknowledges Campbell County Hospital District cooperated with this audit. 

“We are appreciative of the State for working well with our organization, and bringing to our attention their concerns with our Summer Program. It has been a great learning experience for our hospital,” said Campbell County Health Board Chairman Adrian Gerrits. 

“It is important for the success of Wyoming Medicaid that all providers bill the program accurately and honestly because Wyoming Medicaid pays for medical care for some of Wyoming’s most vulnerable citizens.” said Attorney General Bridget Hill. 

“I want to applaud the Medicaid Fraud Control Unit for their work in this case and for their continued work protecting the Wyoming taxpayers’ funds used to finance Wyoming Medicaid,” Hill added. “I also want to thank the Campbell County Hospital District for cooperating with our audit and working with us to resolve this matter.”

From the release:

“The Wyoming Attorney General’s Medicaid Fraud Control Unit investigates and prosecutes Medicaid fraud, false Medicaid claims, and related criminal and civil violations committed by Wyoming Medicaid healthcare providers.”

“The Unit also investigates and prosecutes instances of abuse, neglect, or financial exploitation by Medicaid providers and in Medicaid funded healthcare facilities. The Unit receives 75% of its funding from the U.S. Department of Health and Human Services under a grant award totaling $344,536 for federal fiscal year 2021.”

“The remaining 25%, totaling $114,841, is funded by the State of Wyoming. Wyomingites who suspect healthcare fraud, false claims, or related activity are encouraged to report it by calling the Medicaid Fraud Control Unit’s Hotline at 1-800-378-0345, or visit its website.”