Insurance Fraud NEWS
Medicaid expansion, fighting fraud, equally important
April 21, 2019, Baton Rogue, LA
As Louisiana’s Secretary of Health and a practicing physician, my mission is to improve the health of the people of this state. I am exceptionally proud of the work we have done to increase access to health care services. Nearly 480,000 low-income Louisiana residents have gotten coverage through Gov. Edwards’ Medicaid expansion, many for the first time in their adult lives. They can now see a primary care doctor when needed and get regular preventive care, rather than waiting until they’re so sick they need to go to the emergency room.
What’s more, Medicaid expansion comes at no additional cost to taxpayers because it is paid for entirely with federal funding and fees paid by Medicaid insurance companies and hospitals. By expanding Medicaid, Gov. Edwards brought our federal tax dollars home, which has contributed to our state’s economic growth. An analysis by LSU estimates that Medicaid expansion created more than 19,000 jobs and generated $3.5 billion in economic activity in 2017 alone. It comes as no surprise that 76 percent of Louisiana residents approve of Medicaid expansion.
I detest fraud and waste in Medicaid, because I know that any misspent dollar is one that could have paid for health care services for those truly in need. My top priority is to ensure every dollar spent goes toward providing health care to people who need it most.
Most notably, I have overseen the overhaul of our Medicaid eligibility system. When the Edwards Administration began in 2016, I inherited an outdated system that relied on manual entry of applications and data. This limited our ability to verify applicants’ income and left us prone to human error. We now have a state-of-the-art eligibility system that can access 20 different databases, including wage and tax information, to ensure that only those who are eligible are enrolled.
I have made program compliance and fraud detection part of our daily activities. Since 2016, I have expanded our Program Integrity office, embedded internal and external auditors within the Department, and implemented the suggestions from the Medicaid Fraud Task force and Legislative Auditor to tighten oversight of the program.
We are now a national leader in combating fraud and abuse, performing better than most states on federal anti-fraud measures. In 2017, the Department of Health and Human Services reviewed how we address fraud allegations. Their audit concluded that in 100 percent of the cases, we took the appropriate action and they made no recommendations for improvement. Still, I continue to look for additional ways to root out wasteful or improper spending. By doing so, we can best direct resources to those who need them most and away from those who do not.
While we have accomplished a lot, there is much work to be done to improve health outcomes. That is why I will continue in my quest to be the best possible steward of public dollars and to direct limited health care resources only to those who qualify for assistance.
Source: Daily Advertiser