Medicaid fraud cost Louisiana as much as $85 million

How LDH plans to fix it
Updated: Nov. 14, 2018 at 6:37 PM CST
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BATON ROUGE, LA (WAFB) - Louisiana spent between $60 and $85 million providing Medicaid coverage to recipients who were ineligible for the program because they made too much money since the program’s expansion in 2016, according to a new report from the legislative auditor.

Because the Louisiana Department of Health (LDH) required Medicaid recipients to self-report income changes, recipients who received a raise or got a new job could continue receiving Medicaid coverage until they notified the state or attempted to renew their coverage, which recipients have to do every 12 months.

Hypothetically, an unemployed, single person could apply for Medicaid in January, take a well-paying job in February, choose not to notify LDH, and continue on Medicaid insurance until they had to report income to renew in January of the following year.

“If we don’t get [eligibility] right, it’s inevitable. We’re throwing money away and it’s precious dollars that we shouldn’t be throwing away,” Rep. Tony Bacala, R-Prairieville, said. Bacala serves on the Medicaid Fraud Detection and Prevention Task Force, which raised concerns about this issue months ago.

LDH Secretary Rebekah Gee says the department is planning to implement a new system that will use Louisiana Workforce Commission data to check income figures. Medicaid Director Jen Steele says LDH hopes to get quarterly updates.

“It guarantees that we preserve resources for those who are eligible,” Steele said. “That’s certainly our top priority and making sure that we make good use of taxpayer dollars.” Bacala said. LDH, along with the fraud task force, has been working diligently to correct the issue.

Wednesday, U.S. Sen. John Kennedy called for Gee’s resignation because of the audit. The Governor’s Office dismissed the claims as political posturing.

Bacala noted the problem dates beyond Gee’s tenure, which is why LDH signed a contract to implement the new system in 2015. Most of the misspent dollars are federal match dollars, not state tax revenue.

“It doesn’t matter where the money comes from,” Bacala said. “It’s taxpayer money and it should be spent wisely. We have a responsibility as legislators to spend state and federal dollars wisely.”

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