Standard Excuses Are Wearing Thin
Efforts to eliminate fraud in West Virginia’s Medicaid program are inexcusably backlogged – with 23 complaints at least four years old – legislators were told last week.
If you’re a veteran watcher of the state bureaucracy, you may be guessing right now how Medicaid officials responded to the fiasco, and you’d be correct:
“We are looking at technology to help us work smarter,” lawmakers were told by state Medicaid Commissioner Nancy Adkins. And, of course, more people are being hired to work in the Medicaid Fraud Control Unit.
How many times have taxpayers, upset over inefficiency and outright incompetence in government, heard the same lame excuses?
Legislative auditors said the fraud unit has a backlog of 171 cases involving Medicaid billings from health care providers, including the 23 that are at least four years old. That could represent millions of dollars in fraud.
Last year, the fraud unit recovered nearly $20 million in Medicaid overpayments, Adkins told legislators. She added the unit’s annual budget is about $1 million.
Clearly, then, curbing Medicaid fraud is good business. State officials have known for years the unit could not keep up with complaints. Why are new personnel just now being hired? And will the new technology actually help, and at what cost?
Lawmakers should wait no more than four months, until their regular session next year, before demanding to see an improvement in the fraud unit.