Does Your State Have Medicaid Fraud and Payment Errors?

Taxpayer dollars lost to waste, fraud, or abuse are dollars that cannot fund services for those who truly need the services.

Beth Wood, who serves as North Carolina State Auditor, reported the “state Department of Health and Human Services improperly paid more than $100 million in Medicaid claims during fiscal year 2018.” The “errors” consisted of “overpayments to providers, along with benefits paid to ineligible recipients.”

North Carolina’s audit is just one of many examples of states uncovering errors and fraud within Medicaid. States that have audited their Medicaid programs have found shocking results. Jonathan Ingram at the Foundation for Government Accountability describes some of the Medicaid fraud findings from around the country.

• Michigan identified more than 7,000 lottery winners who were still collecting welfare, some with jackpots as high as $4 million.
• Illinois uncovered more than 14,000 dead enrollees on Medicaid.
• Utah and Maine found that individuals were using their welfare benefits exclusively out-of-state.
• Arkansas discovered more than 20,000 individuals with high-risk identities, including people using stolen identities or even fake Social Security numbers, who were enrolled in its program.
• In Louisiana, the legislative auditor made a random selection of 100 Medicaid recipients and determined that 82 of those individuals did not qualify to be receiving all their benefits.
• In March of 2019, Oregon announced that a Medicaid audit would save the state over $100 million annually by ending improper payments to people who didn’t qualify for the program.

Medicaid mismanagement and fraud not only are wasteful of taxpayers’ dollars, but it also hurts those who truly need services. In North Carolina’s case the Department of Health and Human Services “overpaid an estimated $71.7 million that could have been used to provide additional services to other eligible beneficiaries or reduce overall program costs.”

For most states, Medicaid is a leading budget driver and regular program audits and reviews will not only serve taxpayers better but also ensure that people who truly need services are able to get the help that is needed.

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