Lawmakers want cash to cut down on Medicaid fraud
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Lawmakers want cash to cut down on Medicaid fraud

Date: January 29, 2013
By: Brendan Cullerton
State Capitol Bureau

JEFFERSON CITY - Despite much vocal opposition of Gov. Nixon's Medicaid expansion proposal, state lawmakers have expressed interest in additional funding for a different Medicaid related program--a state unit that works to expose Medicaid fraud.

The group, which is part of the Department of Social Services, investigates potential Medicaid fraud and reports violators to the Attorney General's office. The head of the unit, Markus Cicka, stated his case to state Representatives that increased technology funding would save the state money in the long run. The proposed funds increase is $1.8 million, which Cicka said includes a 90-to-10 federal match of the funds.

Gov. Nixon challenged state lawmakers to work with him on expanding Medicaid coverage in his State of the State Address Monday. Republicans, who hold a veto-proof majority in the House and Senate, said they were not swayed by Nixon's arguments.

"I mean...did you see any Republicans stand up when he said that?" Sen. Rob Schaaf, R-Buchanan, asked Monday after Nixon's speech. "There is zero chance that this Medicaid expansion passes." 

The call for more funding to stop Medicaid fraud received a vastly different response.

"I think if there is any budget worth giving more funds to, it's your shop," Rep. Jeff Grisamore, R-Jackson County, said to Cicka on Tuesday at a hearing of a House budget subcommittee.

Grisamore cited an increase in the enrollment of Medicaid providers as a cause for concern. In the the last quarter of the 2010 fiscal year, Medicaid provider applications jumped from 1,596 to 3,300, according to the fraud unit's study.

Rep. Sue Allen, R-St. Louis County, said Missouri could have saved a lot of money if the government had invested more into this program a few years ago.

Andrea Routh is the Executive Director of the Missouri Health Advocacy Alliance, a non-profit group whose goal is to find affordable health care for all of Missouri. She said added funding to this program could save the state money in the long run by.

"There have been providers that billed the Medicaid for services to beneficiaries that they never provided," Routh said. "They have found a way somehow to say that, for instance, they ran a lab test on an individual that Medicaid would have covered...but they never ran the test, and when they do that on a large scale it can amount to millions of dollars."

Routh also added that, although additional funding for fraud auditing could save Missouri money, it would be nothing compared to how much money Missouri would save by expanding Medicaid coverage.