Attacking Medicaid fraud will save many millions of dollars
May 20, 2012 12:28PM
Updated: July 1, 2012 12:15PM
Attacking Medicaid fraud will save many millions of dollars
A recent Associated Press story, “Questions about Illinois Medicaid cuts, pension reforms,” stated there is little evidence to support the claim that nearly 10 percent of Medicaid in Illinois and nationwide could be fraudulent. There is plenty of evidence that nearly 10 percent of Medicaid payments may be inappropriate, at least that’s what a 2010 federal agency report says about Medicaid nationwide.
According to the U.S. Government Accountability Office (GAO), the federal Department of Health and Human Services calculated in its 2010 agency financial report that on the basis of individual state error rates from a sample of 17 states reviewed on a rotating basis each year, they estimate a national improper payment rate for Medicaid of 9.4 percent for fiscal year 2010.
The GAO report states improper payments to providers that submit inappropriate claims can result in substantial financial losses to states. The GAO says Medicaid payments can be improper for various reasons, such as if payments are made for people not eligible for Medicaid or made for services not provided.
A National Conference of State Legislatures report also estimates Medicaid fraud and abuse nationwide to be between 3 and 10 percent.
Even the liberal New York Times estimates that 10 percent of Medicaid is fraud. Medicaid is our state’s largest expenditure — even more than education. A 10 percent savings equates to an astronomical $1.5 billion in savings. Eliminating fraud and specifically those ineligible recipients off our welfare rolls is not only the right thing to do but helps ensure that those who truly need our care, primarily children and the elderly, get the assistance they need, and that our providers are reimbursed in a timely fashion.
Unbelievably, in a cursory audit of just one Medicaid program (AllKids), the Illinois HHS Director earlier this year admitted to some troubling findings when they mailed out monthly Medicaid cards. The agency discovered, incredibly, that nearly 6 percent of the mailings were returned as undeliverable with out-of-state addresses.
Kirk W. Dillard
State senator, 24th District
Hinsdale
