Missouri Senators Form Medicaid Fraud Panel

Jefferson City, Mo.

Missouri lawmakers have put together a special committee to investigate Medicaid provider fraud in the state.

The committee was formed by Missouri Senate leaders after a series of stories in The Kansas City Star reported that fraud committed by Medicaid providers could cost Kansas $220 million a year and Missouri $575 million.

“If, in fact, the figures The Star presented were anywhere close to accurate, this is a problem far greater than we believed,” Missouri Senate President Pro Tem Michael Gibbons, who officially formed the committee, told the newspaper.

According to The Star, providers in Missouri and Kansas have billed Medicaid for phony prescriptions, therapy and surgery — and even for treating dead patients.

Debate among state legislators and officials about Medicaid reform has centered largely on the personal responsibility of beneficiaries and ways to utilize technology to streamline costs as opposed to targeting provider fraud.

Last year in Missouri, 100,000 beneficiaries were cut from the Medicaid rolls and funding was eliminated for some DME in an effort to curb Medicaid spending. Most basic DME items, including wheelchairs, oxygen and diabetic supplies, are still covered under Medicaid. But others, such as wheelchair accessories and batteries, hospital beds and orthotics, are not.

The newly formed Missouri Medicaid fraud committee will present a report of its findings and recommendations to the state’s General Assembly.

In Kansas, lawmakers said The Star’s investigation confirmed the need for an inspector general who would have broad powers to investigate fraud. Legislators also have proposed a law that would prohibit the filing of false Medicaid bills.