Medicaid fraud bill OK’d in House

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Rogelio V. Solis, AP

Rep. Robert Johnson, D-Natchez, asks questions about a bill that would restore a privatized Medicaid service program.

The House passed a controversial Medicaid reform bill on Tuesday despite several unsuccessful attempts from Democrats to derail the legislation.

UPDATE: Medicaid fraud bill passes Senate and goes to governor 

House Bill 1090, known as the Act to Restore Hope Opportunity and Prosperity for Everyone, will amp up the beneficiary vetting process for Medicaid and the Department of Human Services to root out fraud.

The legislation provides for a new computer system to track the Medicaid system and would allow private companies to bid on a contract to do the vetting of beneficiaries.

Democrats’ problems with the legislation ran the gamut from concerns that the stringent vetting would accidentally kick qualified beneficiaries off the rolls to concerns that the third party vendor would add another layer of bureaucracy to state government.

“If you want a more efficient government don’t add another layer of government to something we already do,” said Rep. Robert Johnson, D-Natchez, highlighting an oft-repeated mantra of his Republican colleagues.

But ultimately Democrats’ concerns boiled down to one issue: the proposal, they argued, was rife with unintended consequences.

House of Representatives

Rep. Adrienne Wooten, D-Ridgeland

“I think it’s safe to say that there are way too many unknowns about what will take place if this bill goes into effect,” said Rep. Adrienne Wooten, D-Ridgeland.

Democrats protested the legislation from the moment the House Medicaid Committee introduced it in January, arguing concerns about fraud were unfounded and the bill would unfairly complicate an already difficult application process for low income Mississippians.

Their concerns never abated, even as some Democrats’ amendments stuck to the legislation. In February, an amendment from Rep. Omeria Scott, D-Laurel, passed with bipartisan support. It included providers among the groups to be vetted for fraud.

But Scott argued that the language didn’t go far enough.

Gil Ford Photography

Rep. Omeria Scott, D-Laurel

“You root out fraud, you root out waste, and you root out abuse. And you root it out anywhere,” Scott said. “So I guess we’re left here with the question, why would the Mississippi Senate not want to ferret out waste and abuse whenever it was found?”

“Next year when you come in here and have a $50 million deficit in Medicaid you need to ask some hard questions about what these programs are actually doing?” Scott said. “Who is benefiting from these programs?”

The idea of rooting out Medicaid fraud, in particular, took hold this year in the wake of a January announcement that the agency needed $89 million to close a deficit left by an appropriations shortfall and three rounds of state-wide budget cuts.

On Monday, the House gave Medicaid $60 million in additional funding for fiscal year 2017.

Republicans, for their part, argued that the Medicaid reform bill was a legislative no-brainer. Although neither the costs of implementing the program nor the dollars in fraud reduction were guaranteed, Rep. Joey Hood, R-Ackerman, who presented the legislation, argued that other states had implemented similar programs and saved millions.

House of Representatives

Rep. Joey Hood, R-Ackerman

“This has already been done in other states — Illinois, Pennsylvania, Maine. This is not something that’s not already been done,” Hood said. “This is not something that’s grasping out there. Its’ not going to cost us much … This is only something to look at, to verify and give our Medicaid workers another tool in their toolbox.”

But Rep. Jarvis Dortch, D-Raymond, and other Democrats said the bill did not clearly outline the tools that the third party vendor would use. And, Dortch argued, the state Medicaid Division did not want the legislation.

“We’re going to look through the process,” Hood said. “I trust the people. I asked Medicaid and (Department of Human Services) to look through the services that’s going to be cost efficient, that’s going to do the job we ask them to do.”

“If you trust the people of Medicaid, so why are we doing this if the people of Medicaid and (Department of Human Services) say it’s unnecessary?” Dortch said.

Medicaid is not the only agency struggling financially. On Friday, state economists downgraded revenue projections for fiscal year 2018 by another $175 million dollars, a point Hood highlighted.

“All we’re trying to do is make sure the people who apply for these benefits qualify for these benefits because any of the money we save on this could go to roads and bridges. It could go to the Department of Rehab (Services) or traumatic brain injuries,” Hood said, mentioning other areas of the budget that legislators had said needed money. “That’s a lot of money we can save and get back into the system.”

The Senate is excpected to consider the bill on Wednesday.