That’s the conclusion drawn from the department’s
latest attempts at damage control after scathing audits of its Medicaid provision.
One
identified very likely at least $62 million in improper payments on behalf of
the Medicaid expansion population through the first part of 2018. In fact, because
the figure looked at just a fraction of all enrollees, about five percent, the
figure could be much higher.
The audit illuminated that LDH’s headlong attempt
to qualify and stuff as many people as possible into the program unnecessarily
led to that waste. In particular, under Edwards it reversed a decision that the
state verify eligibility from an “determination state” to an “assessment state,”
which the state only had implemented at the end of the former Gov. Bobby
Jindal Administration because of the high error rate.
The more exacting Jindal requirement entailed using wage data. But Edwards dispensed with that, with his administration alleging that the error-ridden data suddenly had improved significantly over the previous few months and that it would be too burdensome on existing resources; in short, it needed more money to hire more people to do the additional vetting.
In addition, once enrolled, LDH only occasionally checked
on that recipient’s wage data. Again, the department claimed it didn’t have the
personnel to do this more often as did many states, especially with an
antiquated computer system, recently replaced, that collated the data.
Please. It’s asinine to suggest that, with a $14
billion annual budget with around $4 billion in state money, LDH couldn’t divert
a tiny sliver of that – even one-hundredth of the state portion could hire ten
people – for that task.
The agency also crowed that the new system,
implemented in the past couple of weeks, would cut down on the errors – and again
claimed budgetary woes played a part by delaying system implementation, although
that occurring under the Jindal Administration.
While it’s characteristic for Edwards and his
mandarins to take a page from the former Pres. Barack
Obama playbook and blame consequences they have created on his predecessor,
in this instance the Jindal Administration had started the modernization effort
in 2014,
giving Medicaid eligibility verification priority. The Edwards Administration only
awarded the contract last year. And that has nothing to do in any event with
the politicized decision to change from determination to assessment.
Then there’s the other
audit that faults LDH for activities involving improper payment detection and
resolution. It discovered about two-thirds of cases had incomplete information,
LDH largely ignored investigation of areas with the largest dollar amount
potentially at risk, decreased reviews for improper payments while LDH eschewed
methods that could have stemmed that, and it cavalierly settled cases that could
have recouped the state more money otherwise.
LDH admitted these shortcomings, but blamed some
of it on … wait for it … budgetary constraints.
Again, this is a laughable assertion; the money was there – and more of it than
ever as Edwards has overseen an increase in the range of $4.5
billion or almost 50 percent more spent a year on health care since taking
office – but the will to spend it in a way that might limit improper Medicaid
provision wasn’t.
The will wasn’t there because of the political
imperative to pass out more of the goodie of Medicaid, particularly the new
trinket of expansion, to win political support. The more people getting stuff
(and misled to think it was “free”), the more potential votes Edwards could
harvest for reelection purposes. If you had to crack a few taxpayer eggs to get
there, so be it.
With health
care swallowing almost half of the state’s entire budget, Edwards
recognizes it as the major tool to buy votes. LDH’s attempt to explain away its
lackadaisical enforcement efforts by poormouthing rings patently false, and its
trying to deflect attention from its strategy of benign neglect exemplifies chutzpah.
No comments:
Post a Comment