Hospital Post Payment Audit
MPRO is Changing the Way We Perform Post Payment Audits
The Office of Health Services Inspector General, an independent office within the Michigan Department of Health and Human Services (MDHHS), has contracted with MPRO to conduct reviews of individual hospital based claims.
These audits and reviews will be performed to ensure compliance with applicable laws, rules, regulation and policies of the Michigan Medicaid program pursuant to the Social Welfare Act, 1939 PA 280, MCL 400.1 to 400.119.
What is changing is how the claims are evaluated. From now on, only overpayments will be returned to Medicaid through MDCH and will be done on a case-by-case basis.
MPRO’s main priority is helping to assure the Michigan Medicaid program continues to be available for eligible beneficiaries in the future.
Information about how to access your facility's specific audit information will be coming. Check this web page for updates.
If you have any questions, please contact Toria Spencer at 248-465-7368.