Audit provides assurances about new Medicaid computer system
Operates as intended, but some clean up is still needed
SALEM – An audit report issued on Thursday concluded that Oregon’s major new computer system that processes Medicaid payments is operating as intended. The Medicaid Management Information System (MMIS) used by the Department of Human Services (DHS) has adequate checks over the accuracy of the payment calculations, the data is protected, and programming changes are well-managed. About 530,000 Oregonians depended upon the Medicaid payment system, which paid approximately $2.6 billion to medical providers in fiscal year 2010.
“This is an important element of our Medicaid system and the upgrade was a multi-year effort by DHS,” said Secretary of State Kate Brown. “We are pleased to see it functioning as it should.”
While the audit found that the MMIS was currently operating as intended, problems during startup caused some over- and under-payments to health care providers. In total, these errors represented less than one percent of Medicaid payments processed through the system. The audit recommended that DHS resolve these matters. In addition, some minor security issues were reported to the agency in a confidential letter.
“Because of the Oregon Health Plan the MMIS has unique design features, while also ensuring that providers are not paid more than permitted,” said Audits Director Gary Blackmer. “For example, the software performs 800 edits and audits on transactions, which we checked for appropriateness.”
The audit report including the agency response can be found at www.sos.state.or.us/audits
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