Medicaid Fraud Exagerration
03/30/2010 | 09:08 AM
Gov. Beverly Perdue has loudly proclaimed her new
initiative to stop Medicaid fraud. The heart of
her claim is the use of new technology by IBM to
review claims before they are paid. This is a
great idea.
But her press release is highly misleading. As Lieutenant Governor from 2003-2008 she was culpable in not supporting this technology.
In 2003 Republican Senator Robert Pittenger introduced SB 985 titled Medicaid Fraud Detection Pilot Funds to finance and use this technology. The bill was referred to the Committee on Appropriations/Base Budget and never heard on the Senate Floor. However, on April 29th 2003, Senator Pittenger offered a floor amendment to the Budget Act which passed 49-0 and further expanded direction relating to fraud software. Meanwhile, in the House Republican Representative John Blust offered the same bill. Legislative leadership refused to let it be heard, even though it had passed 49 to 0 in the Senate.
We have attempted to find out who, on the Conference Committee, made the decision to leave this provision out of the final budget for 2003. It was quickly dropped and we find no evidence that Senate conferees fought to include this Republican amendment. Staff states the written record does not exist. But since the Conference Committee overwhelmingly consists of Democratic members, the budget leaders, including then Lt. Governor Bev Perdue and Senator Kay Hagan, are culpable.
One estimate is that since 2003 a billion dollars of fraud, waste and other improper payments have been made in North Carolina. These could have been stopped with this technology.
In 2009, sensing an opportunity (because of the budget crisis) to implement a program that would save money, Republican Representatives Stam, Blust and Dollar introduced HB 190 to accomplish this function. It passed the State Government Committee, and then, in a different form and at the continued persistent insistence of Republican leaders, was included in the House budget, finally accepted by the Senate and signed by the Governor.
Republicans were delighted that the Democrats finally agreed that it was time to save money.
But her press release is highly misleading. As Lieutenant Governor from 2003-2008 she was culpable in not supporting this technology.
In 2003 Republican Senator Robert Pittenger introduced SB 985 titled Medicaid Fraud Detection Pilot Funds to finance and use this technology. The bill was referred to the Committee on Appropriations/Base Budget and never heard on the Senate Floor. However, on April 29th 2003, Senator Pittenger offered a floor amendment to the Budget Act which passed 49-0 and further expanded direction relating to fraud software. Meanwhile, in the House Republican Representative John Blust offered the same bill. Legislative leadership refused to let it be heard, even though it had passed 49 to 0 in the Senate.
We have attempted to find out who, on the Conference Committee, made the decision to leave this provision out of the final budget for 2003. It was quickly dropped and we find no evidence that Senate conferees fought to include this Republican amendment. Staff states the written record does not exist. But since the Conference Committee overwhelmingly consists of Democratic members, the budget leaders, including then Lt. Governor Bev Perdue and Senator Kay Hagan, are culpable.
One estimate is that since 2003 a billion dollars of fraud, waste and other improper payments have been made in North Carolina. These could have been stopped with this technology.
In 2009, sensing an opportunity (because of the budget crisis) to implement a program that would save money, Republican Representatives Stam, Blust and Dollar introduced HB 190 to accomplish this function. It passed the State Government Committee, and then, in a different form and at the continued persistent insistence of Republican leaders, was included in the House budget, finally accepted by the Senate and signed by the Governor.
Republicans were delighted that the Democrats finally agreed that it was time to save money.