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Blunt Spokesman Says Medicaid Reorganization Being Considered

December 06, 2004
By: Ben Welsh
State Capital Bureau

JEFFERSON CITY - A spokesman for Governor-elect Matt Blunt said recent reports criticizing the management of Missouri's Medicaid system show that a reorganization of the program needs to be seriously considered.

While he said nothing specific had been developed, Blunt Spokesman Paul Sloca said the Gov.-elect's transition team has been looking at ways to improve Missouri government which include, he said, an overhaul of the state's Medicaid program.

"There are some concerns raised by the oversight committee and the governor is committed to looking at those issues," Sloca said. "There are no plans on the table right now but we have to look at those concerns and take a thoughtful approach to improve the system."

Inadequate computer systems, poor organization and mistakes by staffers have allowed taxpayer dollars be to misspent by Missouri's Medicaid program, according to two reports issued by the Committee on Legislative Research on Monday.

The committee's investigators found that the state's failure to adequately review the eligibility of Medicaid recipients has allowed unqualified individuals to receive aid money.

The Family Services Division of the Department of Social Services oversees Missouri's Medicaid program. Medicaid is a joint program between the federal and state government that provides medical care to poor citizens. According to state records, over 980,000 people currently receive benefits.

The committee which issued the report is chaired by House Speaker Rod Jetton, a Marble Hill Republican who led the charge to roll back Medicaid entitlements in the last legislative session.

The report reviewed active state employees on Medicaid and found 325 who received assistance at the same time they were drawing benefits from the health insurance program provided for state employees. The report says there may be some cases where the pay out was warranted but notes that the duplication has cost $1,836,000 in state funds.

The committee also reported that an evaluation of 125 case files discovered a failure to detect applications with outdated information or fraudulent financial statements. Investigators found recipients receiving Medicaid despite having home addresses, and sometimes jobs, in other states.

To blame, the reports say, is under-staffing and poor training at social services as well as a lack of rigorous investigation and poor money management at Attorney General Jay Nixon's office.

Christine Rackers, director of the social services division which handles Medicaid, said she thinks the criticism of the system is helpful but added that she doesn't see an easy way to totally eliminate all fraud and error in a program as large as Medicaid.

"When you drill down to the nuts and bolts you see there's not one single answer," said Christine Rackers, director of social services division which handle Medicaid. "There's not one corrective action. Instead it takes constant vigilance to all processes."

In a written response to the committee's findings, Nixon praised the oversight committee's efforts.

However, a memo attached to his letter disputes the claim his department failed to fully apply for federal matching funds. It concedes that Nixon's Medicaid fraud investigators overpaid nearly $40,000 that could have been drawn from federal coffers but questions the $125,000 figure laid out by the committee. The memo claims that his office is engaged in an active attempt to regain the money.

The written response goes on to cite the complexity of Medicaid fraud, which often crosses jurisdiction lines both inside and outside of Missouri's borders, as an obstacle to success. It adds that the department has recently hired three new staffers and suggests an increase in the powers of Nixon's officers to press charges would improve the amount of recoveries and convictions.

Jim Gardner, spokesman for the Attorney General's office, downplayed the financial miscues and instead pointed to the success of their fraud recovery unit, which has reclaimed over eight times as much money as their counterparts in Iowa and Illinois.

The oversight committee's report echoes an earlier audit released by state Auditor Claire McCaskill's office in April. McCaskill's team also found problems in how Medicaid caseworkers evaluate eligibility requirements. Her report claimed to have located 1,112 Medicaid recipients who were sent a combined $144,000 after their deaths.