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Draining the Swamp: Medicaid Fraud

by | Dec 12, 2017 | Taxes

(Editor’s note: This is a continuing series by Liberty Nation about waste, fraud, and abuse that is rampant in our Republic. In the last installment, we uncovered the flagrant mishandling of $14M by the Omaha Tribe.)

Merry Christmas Taxpayers! Did you know you are getting fleeced again? This time it’s through the Medicaid program. The Office of Inspector General has completed an audit of Medicaid and found “a substantial and growing percentage” of fraud cases.

The audit was conducted for the fiscal years of 2012 through 2015. In a newly released report which the media is not covering (no surprise there), the Office of the Inspector General registered a 56% increase in fraud indictments. In 2015 alone, 12% of the OIG’s total investigations were related to Medicaid providers. Recipient fraud is also a big part of the problem — that is your fellow citizens scamming the system and the American taxpayer.

The silver lining in the OIG report is that these criminals are being prosecuted at an increasing rate. During the audit period, convictions for illegal activity regarding the Medicaid program were up 34%.

The study concluded that Personal Care Services (PSC) “remain vulnerable to fraud” and need greater oversight. No kidding. But here’s the rub: state Medicaid fraud units are not doing their job. The audit said that “[Medicare Fraud Control Units] report that States have generally not implemented the specific recommendations made to them for strengthening program integrity.”

Medicaid: Big and Getting Bigger

Medicaid (not to be confused with Medicare) provides free health insurance to 74 million low-income people as well as those with disabilities. However, the program is primarily managed by each state, which has broad powers of administration. So, it’s mainly at the state level where Medicaid fraud and abuse occurs.

Now states don’t have to participate in the Medicaid program, but all of them do. Participants are required to:

  • Establish eligibility
  • Determine the scope and types of services to cover
  • Set the rate of payment for their particular state

The program began back in 1965 as an amendment to the Social Security Act and has grown rapidly. As Ronald Reagan once said, “Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth!” Reagan has a point. Just feast your eyes on this little growth chart:

Vertical line indicates 2017

 

In 2016, Medicaid spending grew 3.9% for a total cost to the American taxpayer of $565.5B. This makes up 17% of the Nation’s Total Health Expenditure – also known in government-speak as the NHE. This NHE accounted for almost 18% of our gross domestic product (GDP). That is indeed a heavy lift.

Fraud and abuse of the Medicaid system needs to be choked off at the state level. This OIG report is not good news.  And this is precisely why every Governor and state legislature must be in conservative hands or else the Democrats and compliant Republicans will hold a feast and feed at the trough of your hard-earned money.

(Hat-tip to one of our readers, Dawn, for her assist)

Read More From Leesa K. Donner

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