Tag Archives: Medicaid fraud

Twelve Reasons Colorado should say no to Medicaid expansion

Avik Roy & Grace-Marie Turner in National Review present 12 reasons Virginia, or any state (like Colorado), should not expand Medicaid:

  1. Virginia’s Medicaid spending will explode
  2. Medicaid harms the poor.
  3. Medicaid’s access problems will get worse as more doctors drop out.
  4. Claims about job creation are exaggerated.
  5. Claims about coverage expansion are exaggerated.
  6. Medicaid raises premiums for those with private insurance.
  7. Medicaid’s undercompensated care is a bigger problem than providing uncompensated care for the uninsured.
  8. Expanding Medicaid will expose [states] to immense amounts of fraud and waste.
  9. [States] will be exposed to higher Medicaid costs when Washington recalculates its matching payments.
  10. By rejecting the Medicaid expansion, Virginia encourages other states to do the same, reducing waste of taxpayer dollars.
  11. Medicaid will worsen the cycle of dependence and harm the economy.
  12. Exchanges will provide better health outcomes, far less fraud, and fiscal certainty.

Read details on each: Twelve Reasons to Say No – National Review Online.

For more on Medicaid expansion, see posts on .

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Independence Institute’s Linda Gorman in Denver Post: Hickenlooper’s plan to finance Medicaid expansion is “reckless,” the “pie in the sky they always feed us.”

The Denver Post reports:

Colorado plans to expand Medicaid coverage next year to cover more than 160,000 additional low-income adults, aided by cost-control savings of more than $280 million over the next 10 years, Gov. John Hickenlooper announced Thursday.

“This is a step toward what we have talked about for a couple of years: How can we make sure we’re making Colorado the single healthiest state in America?” Hickenlooper said.

Apparently the governor is not familiar with how lousy medical care is for people stuck in the Medicaid ghetto.

The article continues:

The state’s ability to embrace the health-care expansion draws on “a relentless focus on how to control costs,” Hickenlooper said. The Department of Health Care Policy and Financing zeroed in on several areas of projected savings, largely by rewarding value over volume.

The article then quotes from Linda Gorman of the Independence Institute on why these savings are unlikely and that Medicaid expansion is a bad deal for the poor. A better policy, she said would provide them access to commercial insurance.

Read Gorman’s comments: Colorado governor proposes Medicaid expansion – The Denver Post.

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Medicaid’s Cruel Status Quo: It’s a Medicaid Ghetto

Avik Roy writes:

Last week, the editors of the New York Times called the House Republican budget “cruel” because it seeks to reform Medicaid, our nation’s government-run health insurance program for the poor. But, in fact, it’s the Times that is showing cruel indifference to Medicaid’s inhumane status quo, a status quo that will deteriorate further under President Obama’s health care law. …

The New York Times calls [Republican Medicaid reform proposals] “cruel.” But by ignoring the past success of welfare reform, and ignoring the serious problems with today’s Medicaid program, it’s the Times that is seeking to trap sixty million Americans in a government-run health care ghetto.

Read the whole article: Medicaid’s Cruel Status Quo | Fox News.

See also Linda Gorman’s Colorado issue paper: Medicaid Block Grants and Medicaid Performance.

via FIRM

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Colorado SB 12-060 – Improve Medicaid fraud prosecution

Colorado SB 12-060 is an attempt to reduce Medicaid fraud below through reporting requirements and financial incentives for counties. Recall that the Department of Health Care Policy and Financing (HCPF) has little incentive to reduce Medicaid fraud, as for every Colorado tax dollar it spends, the Feds pay the HCPF a dollar taken from a taxpayer in another state.  This is why replacing the matching this policy (“Federal Medical Assistance Percentages”) with a block grant would be an improvement.

As Michael Cannon at Cato summarizes:

The basic theorem is this: market actors have greater incentives to prevent fraud, because it’s their own money on the line.  Politicians are spending other people’s money, so their incentive to prevent fraud is far less.  Therefore, fraud will always be higher in government programs than in similar market endeavors.

And here’s a shocker: Medicare & Medicaid fraud far exceeds insurance company profits.

Here’s the bill summary. (The absence of capital letters is in the original bill.)

SB 12-060 – Improve Medicaid fraud prosecution
Sponsor: Senator Ellen Roberts
Description: The bill requires the department of health care policy and financing (HCPF) to submit a written report annually to the health and environment committee and the judiciary committee of the house of representatives and to the health and human services and judiciary committees of the senate concerning client fraud in the medical assistance program. In addition, the attorney general’s office is required to submit a written report annually concerning provider fraud.

The bill also changes the amount of a county’s share of recoveries of fraudulently obtained medical assistance when the recovery is initiated by a county department, county board, district attorney, or HCPF on behalf of the county. Instead of sharing one-half of the state funds paid with the state, the county may retain the full amount of the recovery after payment of the federal government’s share.
Hearing: Senate Health and Human Services at 1:30 PM in SCR 356
Contact the Senate Health and Human Services Committee by clicking here

Via Colorado Senate News.

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Improving Medicaid with block grants & consumer-directed health care

Linda Gorman, director of the Independence Institute’s Health Policy Center has written an issue brief on the benefits of replacing federal matching funds with Medicaid block grants. An excerpt:

If Medicaid were turned into a block grant program in which the federal government gave each state a set amount of money, it could improve patient care, restrain the growth in costs, reduce complexity and improve outcomes. Furthermore, block grants could be used to implement consumer-directed reforms that allow Medicaid enrollees to control some of the spending on their care and give them incentives to avoid unnecessary care.

Read the whole brief: Medicaid Block Grants and Consumer-Directed Health Care, National Center for Policy Analysis.

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Why Medicare & Medicaid fraud dwarfs commercial endevours

Michael Cannon at Cato summarizes:

The basic theorem is this: market actors have greater incentives to prevent fraud, because it’s their own money on the line.  Politicians are spending other people’s money, so their incentive to prevent fraud is far less.  Therefore, fraud will always be higher in government programs than in similar market endeavors.

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Entitlement Bandits Rob Medicaid/Medicare

Michael Cannon at Cato writes:

The budget blueprint crafted by Paul Ryan, passed by the House of Representatives, and voted down by the Senate would essentially give Medicare enrollees a voucher to purchase private coverage, and would change the federal government’s contribution to each state’s Medicaid program from an unlimited “matching” grant to a fixed “block” grant. These reforms deserve to come back from defeat, because the only alternatives for saving Medicare or Medicaid would either dramatically raise tax rates or have the government ration care to the elderly and disabled. What may be less widely appreciated, however, is that the Ryan proposal is our only hope of reducing the crushing levels of fraud in Medicare and Medicaid.

The three most salient characteristics of Medicare and Medicaid fraud are: It’s brazen, it’s ubiquitous, and it’s other people’s money, so nobody cares.

Read Cannon’s whole article, originally published in National Review: Entitlement Bandits — How the Ryan Plan Would Curb Medicare and Medicaid Fraud.

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