The federal Department of Health and Human Services is demanding that the State of California give back what the feds claim is $627,000 in unallowable costs run up in San Diego for contraceptive supplies wrongly used as protection against venereal disease. “Family planning services prevent or delay pregnancy or otherwise control family size,” explains a June audit of the state’s Medicaid program. It goes on to say that out of a sample of 17 claims that were paid to the state and later examined by auditors, “10 were ineligible for reimbursement because the primary purpose of the drugs or supplies was not family planning, 6 were ineligible for reimbursement because of insufficient documentation, and 1 was eligible for reimbursement … because the drug was provided for treatment of a complication.” In the case of the ten drug-related claims, “the primary purpose of the drugs or supplies was not family planning. Of these…seven were for contraceptive supplies (for protection against sexually transmitted infections) provided during visits for testing or treatment of sexually transmitted infections.
“The remaining three claim lines were for oral contraceptive drugs provided to treat a medical condition, such as severe premenstrual symptoms and acne. Because no family planning services were provided during the visits, these claim lines were not eligible for Federal reimbursement.” The audit noted that, “From October 1, 2008, through September 30, 2010, the State agency claimed approximately $38 million for family planning drugs and supplies provided…in San Diego County.” State Medicaid officials agreed with the auditors’ findings and promised to change their ways.