Missouri best in using federal aid to combat Medicaid fraud, other states fight over federal rules

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Jan 18 2010

The Kansas City Star reports that Missouri led the country in 2008 in efficiency in using federal dollars to combat Medicaid fraud. "The state recovered almost $29.8 million in 2008, the most recent year for which comparative data are available, while receiving about $1.6 million in federal Medicaid fraud grants. That equates to $18.81 recovered for every dollar received — 43 cents better than the next-best state" (Noble, 1/12).

The Kansas City Business Journal reports that "Idaho had the lowest return rate at 6 cents for every grant dollar" (1/12).

In Kansas, 5,700 people with physical or developmental disabilities are waiting for services funded by Medicaid, the Kansas Health Institute News Service reports. The services are designed to keep them out of nursing homes or state hospitals, but "state officials said because the demand for services exceeds what the state is willing to spend most years, waiting lists are inevitable. … According to forecasts, the state will be about $300 million to $400 million in the red if it doesn't raise taxes or cut spending for fiscal 2011, which begins July 1. About $1 billion in state spending has been cut in the past year" (Ranney, 1/11).

In Utah, federal regulators are rejecting the low pay Utah gives its dental providers who see Medicaid patients, The Salt Lake Tribune reports. "Last session, state lawmakers took back a one-time 24 percent jump in pay that dentists received in 2008, on top of rolling back their 4.5 percent cost of living raise. … Gov. Gary Herbert recommended restoring the funding for fiscal year 2011, a move the Legislature would have to approve. That action is likely moot, however, since the Centers for Medicare and Medicaid Services (CMS) has rejected the state's Plan Amendment, which it is required to file when it changes its reimbursement to providers. ... Whether the dentists' previous rate will be fully restored isn't clear. CMS wants the state to negotiate with dentists for a reasonable fee" (Rosetta, 1/12).

In the meantime, Florida officials say they'll challenge the requirement that people buy health insurance coverage under the proposed federal health reform bills, Health News Florida reports. "It isn't clear what would happen if the state refused to make the changes necessary to comply with the federal law. In other federal legislation, such as federal highway speed limits, states have been persuaded to go along by threatening to withhold federal funds" (Sexton, 1/12).

Finally, the District of Columbia announced Monday it's getting $26.4 million from the National Institutes of Health to help combat the city's HIV/AIDS epidemic "with expanded testing and treatment to reduce the level of the virus in its victims and hopefully decrease their chances of spreading the disease," The Washington Post reports (1/13).

This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.