Lt. Gov. Tate Reeves presides over the Mississippi Senate. Credit: Gabriel Austin, Mississippi Today

Senate Republicans completed action Wednesday on a sweeping Medicaid fraud bill that Democrats tried vainly to stop.

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

The legislation passed the Senate 30 to 17, on a mostly party line vote and goes to Gov. Phil Bryant for his signature. The House passed the bill Tuesday, also mostly along party lines.

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.

Senate and House Democrats called the new system a waste of money and argued that the Republicans were passing a bill they didn’t fully understand.

Senate Medicaid Chairman Brice Wiggins, R-Pascagoula, defended the final bill, arguing that similar programs had uncovered millions of dollars in other states.

“The gist of the bill is about verification and (using) the tools that are out there, the databases, to ensure the right people are getting the right services and what’s been seen in other states through the implementation of similar legislation,” Wiggins said. “There are people, I’ll put it this way, gaming the system and we want the right people getting the right benefits.”

“How many people in the state of Mississippi out of 3 million are not deserving?” asked Sen. David Jordan, D-Greenwood. “Do you have a number of those who are deserving the services and a number of those who are riding the system who are not?”

“That’s the purpose of the bill … to find out who is doing that,” Wiggins responded.

Senate Democrats argued that the Legislature needed more concrete information on how much money the new vetting process would save before investing money in a process that might not gain the projected savings.

The two sides differed about the costs of the new system.

When asked about how the price tag on implementing the system, Wiggins frequently cited a report from the Stephens’ Group estimating the program would cost each agency approximately $500,000 to implement this year.

Sen. Barbara Blackmon, D-Canton, said her own estimates ran as high as $12 million for implementing the program statewide. And she said Mississippi didn’t have extra money to spend on a program it couldn’t be sure would work.

“Mississippi is about to embark upon something, with the limited or no resources we have, we’re going to ferret out fraud by increasing the moneys we have to expend on the Medicaid program,” Blackmon said.

Wiggins frequently reminded Senate colleagues that part of the bill’s language guaranteed that the “savings (in fraud) must exceed the costs” of implementing the program.

Democrats wondered how that would work.

“So we’re going to issue an (request for proposals) to vendors to say that they have to find fraud that exceeds $500,000 in order for them to get this contract?” Blackmon said.

“What happens if the contact gets cancelled? Is (Medicaid) going to be able to do another $500,000 contract to start it up again?” asked Sen. Bill Stone, D-Holly Springs.

Ultimately, however, Democrats’ protests did little to sway their Republican colleagues, who voted overwhelmingly for the legislation.

“I said when we passed this the first time, ‘what’s good for the goose is good for the gander.’ It’s good policy and we’re protecting the taxpayers’ money,” Wiggins said.

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Larrison Campbell is a Greenville native who reports on politics with an emphasis on public health. She received a bachelor’s from Wesleyan University and a master’s from Columbia University's Graduate School of Journalism.Larrison is a 2018 National Press Foundation fellow in public health, a 2019 Blue Cross Blue Shield Foundation of Massachusetts fellow in health care reporting and a 2019 Center for Health Journalism National Fellow.

One reply on “Medicaid fraud bill survives Democratic fight”

  1. The title, “Act to Restore Hope Opportunity and Prosperity for Everyone,” equals anything by George Orwell.

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