Task force targeting Medicaid fraud, abuse likely to continue work beyond this year
"I think it's opened up some eyes about what we can do when we all work together and share information," said Rep.
The group's research has focused on Medicaid eligibility checks, coordination among state agencies, managed care concerns and issues specifically in pharmacy and behavioral health efforts.
One of the most talked about recommendations among the task force's members has been the push to strengthen eligibility determinations, including the use of tax data.
Legislative Auditor
Purpera said his goal isn't to use his office to root out specific people, but to track trends in fraud and highlight any irregularities.
He cited a
The
The task force also wants LDH's fraud unit, Medicaid fraud investigators in the
"On several of the issues we are waiting on reports," Purpera said.
The task force members said they also hope to see progress reports as they continue studying the program for efficiencies.
"I think as the program evolves, we've set ourselves some goals legislatively and administratively," said Sen.
Since the expansion took effect, nearly 465,000 people, mostly the working poor, have been added to the state's Medicaid rolls.
Under the expansion, Medicaid is now available to households that have incomes below 138 percent of the federal poverty level. That's about
State health officials have defended the program's growth, as it has pumped federal funds to pay for the additional coverage.
After gaining coverage through the expansion, nearly 300 cases of breast cancer have been diagnosed, 5,700 cases of diabetes and 14,530 cases of hypertension. Nearly 9,000 patients have received inpatient mental health services at a psychiatric facility after receiving coverage through the expansion and 43,000 through outpatient services. Nearly 7,500 adults have received outpatient care for substance abuse, and 8,340 have received residential substance abuse treatment.
She said LDH is in the process of enhancing its eligibility verification, but cautioned that some of the proposals from the task force could cost the program additional resources.
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