D.C. Government

A dozen hospitals in the District of Columbia filed suit against the D.C. government in October 1990, contending that the District's Department of Human Services had shortchanged them by $46 million for inpatient hospital services over a five-year period. In a 1991 settlement, the District government agreed to pay the various claims. This fact sheet provides information on two aspects of the District of Columbia's Medicaid Program. GAO looks at (1) the causes of the legal action taken by D.C. hospitals against the Medicaid Program and (2) whether the District could be using federal Medicaid money to fund other District programs.

GAO found that: (1) in their suit, District hospitals contended that the District failed to pay them all monies owed them for inpatient hospital services provided between fiscal years 1985 and 1989, because the District consistently underestimated hospital usage and failed to make year-end settlements; (2) the March 1991 settlement provided that the court retain jurisdiction over the payment process until March 1995, that the parties follow six procedures for the payment process, and that the District pay the various claims; and (3) the Health Care Financing Administration (HCFA) believed that it would be difficult for the District to use its federal Medicaid funds for other programs because of HCFA review of required documentation and its control of funds.