Legislative auditors say West Virginia is at risk of losing millions of dollars in federal Medicaid funding because state hasn’t complied with a 2011 directive.
The directive requires states to suspend Medicaid payments to health care providers if fraud allegations are determined to be credible.
A legislative audit says Medicaid has paid at least $17.9 million to providers whose cases were referred to the state’s Medicaid Fraud Unit. The payments could be as a high as $211 million.
The audit was released Tuesday during legislative interim meetings.
Bureau for Medical Services counsel Alva Page told lawmakers that the bureau and auditors have different interpretations of the applicable portion of the Affordable Care Act.