LA MEDICAID AUDIT- There’s been a series of critical reports recently about Louisiana’s $12 Billion dollar Medicaid program, several media reports have revealed the Louisiana State Legislative Auditors Office has discovered hundreds of millions of dollars of Medicaid claims that suggest potential fraud since managed care was put in place in 2012 during Governor Bobby Jindal’s administration. These audits were the topic of the Louisiana Senate Health and Welfare Committee’s hearing Wednesday. Republican Senator Fred Mills, of Parks, La. who chairs the committee underscored the focus of the meeting by saying:
“Let’s understand our risks and exposure and what we can do to mitigate it." Mills said.
The Louisiana State Auditor’s Office discovered more than $2.5 billion dollars in claims from October 2015 through December 2017 that didn’t have valid provider identification numbers and some $13 million in claims where the specialty codes didn’t match. Louisiana’s State Health Department Secretary Rebekah Gee said the department takes the findings seriously but also pointed out the audit doesn’t necessarily reveal fraud but rather a problem in claims management.
“It doesn’t means instances found are necessarily fraud. When there are issues identified let’s immediately correct course if possible," Gee explained.
Some committee members said recent statements from the state auditor’s office revealed in the media have politicized these findings, to which Gee replied, "We are committed to a culture of continuous quality improvement. The point of a legislative auditor isn't to be a 'gotcha guy', into make the department look bad. The point of having a legislative auditor is to have us run a better program."
The committee adjourned with GEE’S assurance that the State Health Department will work with the State Auditor’s Office to explore ways to improve quality assurance in Medicaid claims.