Kaiser Daily Health Policy Report Highlights Medicaid Developments In Washington, D.C., Wisconsin

July 25, 2007 – 10:46 pm | posted in Medicare

Two newspapers recently published articles about Medicaid developments in Washington, D.C., and Wisconsin. Summaries of the coverage appear below.

* Washington, D.C.: The District Office of the Inspector General on Thursday said Medicaid overpaid health care contractors by $96.6 million over the past five years for services that many beneficiaries did not receive, and the program could lose federal funding because certain beneficiary information was not reported, the Washington Post reports. According to an audit of the program, “excess payment” was made to Amerigroup Maryland, D.C. Chartered Health Plan and Health Right. In addition, the District Medical Assistance Administration, which oversees Medicaid, did not review and negotiate contracts with the three companies to ensure the cost of beneficiaries’ care matched their needs, according to the report. The report also criticizes the agency for using a “one size fits all” approach to paying for medical services that provided the same monthly payment per beneficiary whether the beneficiary was sick, healthy or visiting a physician. Assistant Inspector General William DiVello said, “We paid in profits more than we should have,” adding, “We’re not saying the companies did anything illegal. The district just didn’t do a good job monitoring them” (Woodlee, Washington Post, 7/20).

* Wisconsin: Overhauling the state’s Medicaid computer system will cost at least $9.3 million, 28.8% more than originally planned, because of changes to state and federal laws, state officials said, the Milwaukee Journal Sentinel reports. Federal funds will cover 90% of the cost of implementing the Medicaid Management Information System. Records also show that the state is 39,000 worker hours behind schedule, suggesting that the deadline for completion could be pushed back a third time. The deadline originally was January 2008 but was moved to March 2008 (Marley, Milwaukee Journal Sentinel, 7/20).

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