States grapple with Medicaid problems in access, improper payments

The Washington Post reports on the District of Columbia's Medicaid program and mental health coverage. "The federal government handed [the city] an opportunity to save $56 million over four years by expanding Medicaid this summer and they jumped at it. They switched 35,000 low-income residents from the city-funded D.C. Health Care Alliance insurance plan to a Medicaid plan and reaped the reward. It looked like a win-win: The city got some financial relief and the new Medicaid beneficiaries got mental health coverage, which was not part of the Alliance plan. But it creates a problem for the city's mental health care providers, who said this week that they are faced with serving thousands of new clients they are not prepared to manage." Some D.C. officials say there is no evidence the system will be overwhelmed (Fears, 10/12).

In Virginia, the Medicaid program paid out $39 million in improper payments in 2009, including more than $20 million in fraud, the Richmond Times-Dispatch reports. "An additional $48 million in potential fraud or error was avoided by blocking improper claims before they were paid, according to the report by Ashley Colvin, an analyst for the Joint Legislative Audit and Review Commission. … Colvin noted that the improper payments and blocked claims represent less than 2 percent of Medicaid spending in Virginia, which, in fiscal 2009, totaled $4.8 billion" (Whitley, 10/13).

The (Baton Rouge, La.) Advocate: Louisiana is having its own trouble with improper Medicaid payments. "In its effort to recoup dollars overpaid, the state health agency made a second mistake: It deducted much more from physician checks than agency officials had agreed to originally. And like the previous mistake, state Department of Health and Hospital officials blamed a computer glitch. DHH last week mistakenly deducted $3.4 million too much from checks reimbursing physicians for the care they provided the poor through the government's Medicaid health insurance program. The error was made as DHH started recovering $11.6 million that was overpaid to Medicaid providers last year" (Shuler, 10/12).

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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.