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Better Oversight Of Program Vital

October 26, 2012
The Intelligencer / Wheeling News-Register

West Virginia taxpayers got off the federal government's hook relatively easily when the U.S. Department of Health and Human Services uncovered mismanagement of an important Medicaid program. That is not likely to happen again, so the state needs to correct glaring flaws identified by Washington.

An audit by the DHHS inspector general's office found major problems with a Medicaid program that helps elderly and disabled West Virginians stay in their homes instead of being shipped off to more expensive facilities such as nursing homes.

We have championed that program for years. It is good for senior citizens and the disabled who prefer to live at home. It also is good for taxpayers because providing home health care and living assistance often is cheaper than paying for nursing homes.

Though Medicaid is a state program, most of the money for it comes from Washington. That gives the DHHS power to set the rules and to conduct audits.

DHHS auditors looked at the Mountain State program's records for a two-year period and ruled the federal government had paid for between $360,000 and $3 million worth of home health care services improperly. In 10 percent of cases investigated, the state was paying for services that had not been documented. Auditors found some companies had billed the state for services the firms' own records did not show had been provided.

This time around, someone in Washington apparently took pity on West Virginia. Instead of demanding repayment of the entire $3 million, the DHHS is insisting on only $360,539.

That is still a lot of money but, again, it could have been much worse.

West Virginia's Medicaid program is handled by the state Department of Health and Human Resources. But the state agency has contracted with the Bureau of Senior Services to manage the in-home care program.

Clearly, the bureau is doing a lousy job. Required oversight simply is not being provided.

That needs to change immediately. Otherwise, officials at the federal level will lose patience and, the next time an audit turns up deficiencies, the bill may be much higher.

The Bureau of Senior Services is a state cabinet-level agency, reporting directly to Gov. Earl Ray Tomblin. He should insist on documented improvements in performance - or new staff members capable of providing it.

 
 

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