WASHINGTON, DC - The House Energy and Commerce Subcommittee on Oversight and Investigations, chaired by Rep. Tim Murphy (R-PA), today held a hearing to discuss the continued and growing issue of waste and fraud in the Medicaid program. Subcommittee members heard testimony from the Government Accountability Office and the Centers for Medicare and Medicaid Services.
The GAO, a nonpartisan government watchdog, recently released a new report that “found thousands of Medicaid beneficiaries and hundreds of providers involved in potential improper or fraudulent payments during fiscal year 2011 - the most-recent year for which reliable data were available in four selected states: Arizona, Florida, Michigan, and New Jersey. These states had about 9.2 million beneficiaries and accounted for 13 percent of all fiscal year 2011 Medicaid payments."
Seto Bagdoyan, Director of Audit Services at the GAO, testified, “In summary, our analysis of indicators of improper or potentially fraudulent payments revealed thousands of beneficiaries and hundreds of providers involved in potential improper or fraudulent payments during fiscal year 2011 in the four selected states. For example, we found:
* Approximately 8,600 beneficiaries received benefits worth about $18.3 million concurrently in two or more states -- even though federal regulations do not permit beneficiaries to have payments made on their behalf by two or more states concurrently.
* Identities of about 200 deceased beneficiaries received about $9.6 million in Medicaid benefits subsequent to the beneficiary’s death.
* About 90 providers had suspended or revoked licenses in the state where they performed Medicaid services yet they received a combined total of at least $2.8 million from those states."
Murphy noted, “Last year the Medicaid program provided medical services for approximately 60 million people at a cost of $310 billion. But during that same year, the Centers for Medicare and Medicaid Services estimated that the improper-payment rate was 6.7 percent or $17.5 billion. This is an increase of almost 1 percent or over $3 billion from the previous year. This is a troubling trend, especially as the program continues to expand."
Full committee Chairman Fred Upton (R-MI) said, “Medicaid is supposed to provide our most vulnerable with vital medical services, but continued waste and fraud undermines this important goal."
Dr. Shantanu Agrawal, Deputy Administrator and Director of the Center for Program Integrity at CMS, testified about steps currently being taken by CMS to reduce waste, fraud and abuse, but agreed that continued oversight is essential. Dr. Agrawal told Rep. Joseph Kennedy (D-MA), “Holding our feet to the fire is appropriate."
Read complete witness testimony and watch the hearing online here.
