Senate passes Medicaid fraud bill after tense debate

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The Senate easily passed a Medicaid fraud bill Tuesday despite a forceful 11th-hour opposition from Senate Democrats, who argued the legislation could jeopardize services to Mississippi’s poorest citizens.

House Bill 1090, which passed by a 30-17 vote, authorizes Medicaid and the Department of Human Services to contract with a third party vendor to vet the eligibility of new beneficiaries and weed out people who are ineligible for these government services. It also authorizes the vendors to detect provider fraud, such as doctors who bill for services not provided.

Sen. Hob Bryan, D-Amory, kicked off the opposition by questioning whether beneficiary fraud was a serious financial drain in the state, and Sen. David Blount, D-Jackson, followed with questions about just how precise the verification system would be.

MS Senate

State Sen. David L. Jordan of Greenwood

But Sen. David Jordan, D-Greenwood, drove their points home with a personal plea against the legislation, arguing the enhanced verification would unintentionally strip services from thousands of vulnerable residents.

“My parents were share croppers and had no skills, and they died earlier because there were no programs to assist them in their senior years,” Jordan said. “And a lot of people die early because they’re getting cut off. … You have some (fraudsters) doing some things here, but they’re going to be scattered among the people who need the services.”

Senate Medicaid Chair Brice Wiggins, R-Pascagoula, who was presenting the bill, quickly jumped in to reiterate a point House Republicans had also tried to drive home when they passed the legislation in February.

“Sen. Jordan, I agree with you about the people who need the services,” Wiggins said. “And nobody who’s actually eligible for benefits will lose benefits. This is only for people who are taking advantage of the system. We don’t know they’re taking advantage of the system until we pass something like this.”

“But you’re going to hurt the people who deserve this,” Jordan said.

Gil Ford Photography

Sen. Brice Wiggins, R-Pascagoula

“No, nobody who deserves this will be hurt,” Wiggins said. “If you’re doing what’s right and you’re following the law then you have no reason to worry you’ll be denied benefits.”

But Democrats did worry. After Jordan spoke, several other Democrats including, Sen. Derrick Simmons, D-Greenville, and Sen. Sollie Norwood, D-Jackson, continued to question Wiggins about whether fraud was a legitimate problem and to ask how likely it was that eligible beneficiaries could be cut off.

Republicans, for their part, uniformly voiced support for the legislation. After nearly an hour of questions on the bill, Sen. David Parker, R-Olive Branch, stood and offered some statistics he said he had just looked up on how much the bill could potentially save the state.

“Would it surprise you that when Arkansas instituted a similar program, they found 494 dead enrollees and 43,000 enrollees living out of the state?” he asked Wiggins. “Would it surprise you that they found 4,000 people with a property net worth over $100,000?”

Sen. Angela Hill, R-Picayune, also spoke enthusiastically about the potential savings, asking if the bill might offer a way to recoup some of the money that had been lost to fraud.

Other Republicans who voiced support for the bill described it as a way of injecting much needed funding into the state’s Medicaid program, which is now facing an $89 million deficit for this fiscal year after an appropriations shortfall and three rounds of statewide budget cuts. Meanwhile, the budget is steadily on the rise, ballooning to nearly a billion dollars, even as the number of recipients continues to fall.

And while many Democrats agreed that the agency could use funding, they debated whether this bill would actually do that.

Rogelio V. Solis, AP

Sen. Bill Stone, D-Holly Springs

“This dead people thing has intrigued me here,” said Sen. Bill Stone, D-Holly Springs. “When you’re talking about dead people on the rolls, are they receiving services?”

Generally, Medicaid pays only for services a patient receives. Conceivably, a dead person would not seek out services. But Medicaid also pays its managed care companies a per capita rate for beneficiaries, which the agency said they only recoup after receiving notice of the person’s death.

But representatives for Medicaid, who have not come out for or against the bill, stressed that they already have extensive vetting operations in place.

“Our people work hard to actively do all of these things,” said Erin Barham, the agency’s deputy director of communications.

 

  • AllNotWell

    Purge the rolls, then reassess the population’s needs.

  • Jameson Taylor

    This is what the bill does and how much it is expected to save: http://www.mspolicy.org/mcpp_reports/mcpp_reports_view.php?entryID=446 … When lawmakers talk about “dead people,” in this context, they mean the identities/social security numbers of dead people being used to obtain benefits. Sometimes, this is a sign of provider fraud, which the bill also addresses.