An audit of the state’s Medical Assistance shows management problems – but little evidence of fraud. Milwaukee Democrat Jon Richards serves on the Joint Legislative Audit Committee, which approved the audit of the program in January. Medical Assistance provided services to 1.2 million recipients as of January, 2011. “The audit debunked the myth that there was widespread fraud in Medicaid, and debunked the myth that people are moving to Wisconsin to take advantage of Medicaid benefits,” says Richards. The administration of Governor Scott Walker and the state Department of Health Services are seeking a federal waiver to eliminate coverage for 42,200 current recipients and reduce benefits for 263,000 others. “I would ask the Walker administration to recast the way they’re looking at reforming the Medicaid program, and go away from cutting people off of care like they’re currently talking about doing, and do a better job of care delivery,” Richards says.
AUDIO: Representative Jon Richard
Key facts and findings contained in the audit:
Expansion of eligibility and periods of economic recession have increased the number of Medical Assistance recipients.
In January 2011, 61.3 percent of recipients received services through a managed care arrangement.
DHS has not always considered its available spending authority when making contracting decisions.
Not all Medical Assistance-funded expenditures are included as part of the Medical Assistance budget or recorded as the program’s expenditures.
Data systems and budgetary practices limit the availability of basic information needed to effectively manage and oversee the program.
“With a program the size of Medicaid, or course there’s always things you can do better, and we need to do a better job” says Richards. “But I think we should also keep in mind that it’s a program that serves the health care needs of people, and it is the only way that many people get health care coverage. We should be looking at this in the context of how do we keep people insured and covered, and reform the program.”
READ: Richards’ press release (pdf)
