DO NOT PAY MEDICAID OR INSURERS BACK for SDF Audit
According to Andrew C. Pack, Director of the Office of Medicaid’s Program Integrity, the Medicaid MCO’s have been directed NOT to pursue recoveries related to SDF overpayment determinations. Medicaid invalidated their findings due to a lack of policy support.
Mr. Pack stated, “Providers should disregard overpayment notices that include findings based on a lack of patient consent specific to SDF.”
The WVDA asked how dentists would be notified that they do NOT need to payback Medicaid for SDF. The response was as follows “(Dentists) would be notified by the dental vendor if they had non-SDF findings that still need to be resolved.”
If you receive additional correspondence about the SDF audit/payment requests, please notify WVDA so we can help intercede on your behalf.
