This week I introduced House Bill 2015 to save taxpayer money by requiring the Department of Medical Assistance Services to develop a program to mitigate any risks of improper Medicaid payments to providers for services furnished pursuant to the state plan for medical assistance. This needed reform is a way to hold managed care organizations (MCO’s) accountable. This bill builds upon past efforts to likewise bring accountability to Fee For Service providers.
As good stewards of the tax dollar, we must identify ways to tackle fraud and waste that may exist within self-insured employers and government programs. MCO claims data should be identified to see whether payments are being approved, estimates show that approximately 8-15% of all claims identified are either improper, wasteful or worse, fraudulent. This could mean that DMAS is losing well over $600 million a year to fraud, waste, and abuse. This is unacceptable. Especially, when a solution exists to stop it from happening.
I am also happy to join Senator McDougle as a co-patron in support of Senate Bill 1352, a bill to create as an independent state agency the Office of Medicaid Fiscal Oversight and Accountability and charges the agency with the preparation of the Official Medicaid Forecast for the state, monthly oversight of Medicaid expenditures, review of the fiscal impact of policy changes, and other oversight and accountability responsibilities.
HB 2015 can save the very money to finance the Senator’s efforts to enact greater oversight of our state Medicaid program.