Medicaid fraud

To the editor:

Juxtapose the cuts to the Department of Aging budget approved by the Senate Ways and Means Committee last week against Kansas’ D-plus efforts to prosecute Medicaid fraud (reported Jan. 16). The action guts a program that often keeps frail elderly Kansans at home. Yet the recent audit of our state’s Medicaid fraud unit, run by the attorney general’s office, found Kansas is doing a pitiful job investigating fraud and recovering Medicaid dollars.

The audit found the Department of Social and Rehabilitation Services fails to refer cases to the AG’s office, and the AG’s office has failed to seek legislation to look behind SRS records to track down Medicaid fraud on its own. The fraud unit was sent to the AG’s office in 1995. Advocates hoped that health care providers who misused Medicaid dollars would finally be prosecuted. There is no excuse for the AG’s office not to have sought the necessary legislation to look for health care fraud in SRS records in seven years.

Other attorneys general and the Department of Justice have recognized the simple logic that taking Medicaid money for substandard nursing home care is Medicaid fraud, have prosecuted wrongdoers, and recouped the money. The health care contractor who takes Medicaid money and doesn’t meet minimum specifications for quality of care defrauds the government.

If building contractors can be made accountable when they do not meet government specs for government dollars, shouldn’t health care providers be held to a similar standard? Nationally, the focus has been on Medicaid health care fraud for 10 years. Kansas is so far behind the curve, it isn’t funny. Especially if you need home services and see effective programs gutted as public dollars are frittered away on poor nursing homes, while the state agencies responsible for prosecuting Medicaid fraud look the other way. Or even worse, if you are the victim of hospital or nursing home neglect or abuse paid for, without regret, by the government.

Margaret Farley,

Lawrence