OHCA board hires Maine company to recover lost money

Saturday, March 2nd 2002, 12:00 am

By: News On 6

The board of the financially troubled Oklahoma Health Care Authority has voted to hire a collections company to recover money lost because of fraudulent claims and billing errors.

The board voted 4-1 Thursday to hire Health Watch Technologies of Portland, Maine, for $489,188, a fee that includes 4 percent of whatever is recouped. The company provides similar services in Kentucky, Maine and Washington.

Board member Lyle Roggow of Enid voted against the idea, saying he was not confident the company will recoup enough money to pay for itself.

``With the current budget constraints that we have for all state agencies, I just didn't feel comfortable with half a million dollars being spent at this point in time,'' Roggow said.

He added that he would have been more inclined to support the decision had the company been allowed to keep 10 percent of all collections, instead of getting a flat fee plus collections.

The authority, which administers Medicaid funds, recently received a $15.6 million supplemental appropriation but still had to cut some programs and services.

The agency was faced with a $21.3 million budget shortfall by the end of the current fiscal year on June 30.

The agency estimates that it will recoup nearly $1.8 million by the end of the fiscal year, Roland Davila, the authority's manager of contract services, said in a story from the Tulsa World's Capitol bureau.

``It is hard to put an estimate on what is out there,'' Davila said.

Some of it will have to be returned to the federal government, he said.

The authority processes about 1 million claims and pays out about $200 million a month, OHCA spokesman Nico Gomez said.

Health Watch Technologies will evaluate the agency's billing history and determine patterns of abuse or mistakes, Davila said. It will make recommendations on how to prevent abuse, fraud and mistakes and will recover funds at the agency's discretion, Davila said.

``I'm confident, based on (the firm's) track record, this contract will more than pay for itself,'' said Mike Fogarty, the authority's chief executive officer.

The OHCA was criticized for giving pay raises costing $499,361 to 161 employees in July.

A few months later, the authority announced that it was having budget problems, something officials said could not have been foreseen at the time the raises were given.