- The Washington Times - Thursday, October 26, 2006

When Congress approved the Deficit Reduction Act of 2005, it created the Medicaid Integrity Program and granted practical, open-ended authority to the Department of Health and Human Services to fight Medicaid waste, fraud and abuse. Previously, such detection and enforcement was largely in the hands of states. But, since the federal government pays the majority of Medicaid costs, states could turn a blind eye to wasteful spending. But as the federal mandate clearly spells out, “tates must comply with any requirements determined by [Health and Human Services] to be necessary for carrying out the Medicaid Integrity Program.” Here’s a blow of the whistle to federal auditors: The District of Columbia is wasting millions of local and federal taxpayer dollars.

Medicaid waste and fraud are driving D.C. into a hole — and it is $22.3 million deep. In fact, the city spent more on transportation for Medicaid recipients than it did on actual physician visits for Medicaid recipients.

The crux of the daunting issue was laid to bare in an audit by the D.C. Inspector General. In short, it said the District’s Medicaid program is in “serious breach of basic internal controls,” lacking even the most basic documentation for the vast majority of non-emergency Medicaid transportation claims. The audit also found that D.C. Medicaid authorities failed to conduct any onsite visits of transportation companies that provide services.

That lack of “basic internal controls” meant transportation firms received $22.3 million in tax dollars and D.C. officials don’t even know whether they should have or not. For instance, a federal affidavit for one firm, Mash Transportation Inc. in Maryland, found that the company “has filed dozens of Medicaid claims for transporting patients who were dead,” as reporter Jim McElhatton has been detailing this week in The Washington Times.

The Voice of Social Concern Association Inc. started out as a small van company and became one of the largest in the city, receiving more than $1.5 million in Medicaid payments. But federal authorities say the owner committed health-care fraud, wire fraud and other crimes, for submitting thousands of phony Medicaid claims — and in more than 200 of those cases the patients were dead.

It’s easy to get on the receiving end of such D.C. generosity. All an entrepreneur needs is a largesse license, inspected van, insurance and a rate plan on file. Criminal background checks? Practically nonexistent. The Times found several firms were connected to owners or employees with criminal records.

We could point fingers at City Hall, where blind eyes keep auditors busy fishing for coffer receipts all the time. This time, though, we are just grateful that the feds are looking in the right direction.

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