Archive for Friday, August 30, 2013

Editorial: Medicaid fraud

Reducing fraud is a good step toward ensuring that limited Medicaid funds are directed to Kansas families who depend on that help.

August 30, 2013


Kansans should applaud the sentiment expressed by Attorney General Derek Schmidt in a recent press release about his office’s efforts to reduce Medicaid fraud in the state.

“We take seriously,” he said, “our responsibility to ensure that every dollar spent by the Kansas Medicaid program is used to provide legitimate services to Kansans in need.”

Eliminating fraud is a good first step. Schmidt notes that his office recovered more than $33 million in taxpayer funds through its Medicaid fraud enforcement in the fiscal year that ended June 30. The previous one-year high for such efforts was $28 million in fiscal year 2011.

During 2013, the attorney general’s office collected $2.3 million in restitution in 14 criminal cases of fraud and recovered $16.3 million through civil judgments and $15.1 million through participation in national settlements.

There are a couple of reasons that eliminating Medicaid fraud could be even more important in Kansas than in other states. First, Kansas has some of the nation’s toughest income standards to qualify for Medicaid. Unless they are disabled, adults without children cannot qualify for Medicaid assistance in Kansas regardless of their income level. Families with children must have an income below 35 percent of the federal poverty level in order to qualify; that’s $6,000 to $8,000 a year for a family of four. State officials have chosen not to accept federal funding to extend Medicaid benefits to thousands of additional Kansans.

It’s vital, as Schmidt indicates, that every dollar allocated for Medicaid go to the Kansans who need that assistance.

The state’s decision to turn down federal funds to expand Medicaid has been a matter of considerable debate in the state. There should be no debate, however, over the need to make sure every Medicaid dollar in Kansas goes to help families who depend on that assistance. The attorney general’s efforts to curb Medicaid fraud help further that goal.


George_Braziller 4 years, 8 months ago

Some of the "fraud" they found that led to recoupments from agencies during Medicaid audits wasn't fraud. The audits weren't even real audits, they were witch hunts.

All they did was look at a few random files and base their entire decision on that. The "fraud" they found at agencies consisted primarily of incomplete files and paperwork errors.

LawrenceBorn74 4 years, 8 months ago

What should be noted in response to Mr. Braziller. The Medicaid audits he complains of are actually conducted by the Medicaid program. The Attorney General's Office Medicaid Fraud and Abuse division deals with proving actual fraud in either civil or criminal court. The Attorney General's Office does not conduct audits.

George_Braziller 4 years, 8 months ago

I'm not "complaining." The audits Medicaid did were sloppy at best.

DScully 4 years, 8 months ago

Having worked as an optician I saw plenty of fraud, by people who had money, big cars, big house, expensive jewlery, yet managed to hide their money and go on Medicaid so as to not have to pay for their own health care. I also saw fraud on the part of eye doctors.There is fraud out there, but it is not just on the part, as assumed, of those who are needy, but also being done by those who have plenty!!!

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