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Two years ago as businesses were struggling through the recession, a family business in eastern North Carolina that cares for shut-ins and older people in their homes received a letter from PCG Corporation of Boston saying, We’re coming to audit the payments you’ve received from Medicaid.
Earlier, PCG (the ‘Public Consulting Group’) had told the Perdue Administration it had a way to save state government millions of dollars by rooting out Medicaid ‘overpayments’ – and all the state had to do to in return was pay a fee of $250,000 (monthly), plus a bonus based on how many millions of dollars in overpayments PCG identified.
Now, that word identified turned out to be a problem. Because back in 2010 PCG’s bonus was based on the amount in overpayments it identified – and not on the actual cash the state received in refunds for the ‘overpayments.’ It was a prescription for a train wreck but the Perdue Administration bought it ‘hook, line and sinker’ and set the gears in motion that led PCG to the family business’s doorstep.
Right off, it was clear PCG had an unusual definition of ‘overpayments’ – for instance, when the family business had provided all the healthcare and all the services it was paid for by Medicaid, if it failed to check a box correctly on a government form – that was identified as an ‘overpayment.’ And the business had to repay the money.
In addition, PCG didn’t audit all the Medicaid payments the business received – instead it audited a fraction of the payments then extrapolated to estimate how much the business owed for all the payments. In other words, PCG may have audited, say, 100 payments – then extrapolated to determine how much was owed for all of its payments. It sounded reasonable but didn’t turn out that way.
Two years after the business received the first letter from PCG it received another letter saying, Our audit is complete. We identified $650 in ‘overpayments.’ By extrapolation you owe the state $133,000 in refunds.
The business had landed in a fight for its life.
It appealed PCG’s findings, hired lawyers, had a hearing, and here’s the result:
It didn’t owe $650.
It didn’t owe $133,000.
It owed $7.50.
Another business PCG audited and extrapolated received a letter saying it owed $500,000 – it appealed and paid $0. PCG said still another business owed the state $3 million for overpayments – that business appealed too and paid $700.
And the Perdue Administration is still paying PCG $250,000 a month.


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4 comments on “$250,000 a Month

  1. clarence swinney says:

    NRA—if they take your assault rifles, next the automatic hunting rifles, then unarm your home.
    It is like—Speed limits first then take your car. Take your porno tape then your Bible.
    NRA is limp duckling swimming in false info.
    Powerful? Ho Ho Ho. Last election spent 18 Million. Pocket change.
    This crew is broke in money and character.
    Blarney baloney gets few votes from them.
    Fight every progressive program except tax cuts for Rich.
    Name 10 Great programs created by them
    google: clarence swinney + 82 Democratic programs
    Conservatives fought most of them and still do.
    Middle class + poor
    Conservatives still Country Party plus ultra rich protectors.
    Democrats create—Conservatives destroy

  2. clarence swinney says:

    Victims were American Jobs act that would have created
    4 milllion jobs in a great recession
    Clean Energy and Security Act
    Disclose Act
    Dream Act
    Employee Free Choice Act
    Bring Jobs Home At
    Website—Fix this senate now .org
    Worst Senate in history.

  3. clarence swinney says:

    We hear about lowest tax rates in 50 years.
    True. Not this fiscal year.
    2009 was recent record low
    14000 Income took 2100 In taxes or 15%
    Borrowed 1400B
    2013 projects 2900B taxes or 21% effective tax rate

  4. dap916 says:

    1). Middle class + poor
    2). Conservatives still Country Party plus ultra rich protectors.
    3). Democrats create—Conservatives destroy

    1). I’m thinkin’ you meant “Middle class = poor”. hahaha

    2). Care to tell us, swinney, how conservatives are “still Country Party”? I mean, I know all the radical leftwing/progressive B.S. about how they’re the “ultra rich protectors” as you put it, but what’s this “Country Party thingy? Oh, and don’t forget now that 7 of the most wealthy members of congress are democrats, okay? I mean, hey…..just thought you’d like to know hahahahahahahaha

    3). Please, swinney, present us a list of all of the things democrats have created (other than more entitlements which we already know about) vs the conservatives.

    You’re such a joke. I’m thinkin’ you’re either a buddy of Gary Pearce here to continue to get your posts come up very soon after you post them or are some democratic operative that gives this site money and so forth.

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