Stopping medical fraud where it counts
10/19/2006
Barb Goodwin, Bemidji Pioneer
Published Thursday, October 19, 2006
A few weeks ago, House Republicans announced a plan that they claimed would crack down on fraud in our state’s public assistance health care programs.
We’ve already given them an eight-year majority to do this work.
While it’s important to ensure taxpayer dollars are being properly invested with all taxpayer funds, the Republican plan is ignoring the mountain and focusing on a pebble. They intentionally overlook the largest source of potential fraud. It would appear that this is sadly, just another election-year gimmick designed to scapegoat certain groups of people.
The Republican plan focuses on investigating individual Minnesotans who receive public assistance. Rep. Fran Bradley held a politically motivated interim meeting and staged a press conference afterward on welfare fraud. Unfortunately, he only allowed testimony on recipient fraud and refused testimony from several people who called ahead and others who were in attendance who were there to expose potential provider fraud.
What Republicans won’t tell you is that cash payments to welfare recipients amount to a fraction of 1 percent of the state budget. The vast majority of welfare funds are spent to pay providers for Medical Assistance to senior citizens in nursing homes and people with disabilities — people who are hardly in a position to commit fraud. They also fail to mention that the cost of implementing their plans may well exceed the money they expect to save.
In the meantime, the Pawlenty administration and Fran Bradley spend millions to hire and protect companies that have been investigated for fraud and been forced to pay millions in fines in other states. And this administration is spending little to nothing to investigate fraud in the highly expensive health care provider system.
Our main focus on fraud prevention should be on health care providers, insurers and contractors the state does business with. We could save millions.
For example, Medical Transportation Management is a Missouri company in charge of arranging medical transportation for Minnesotans receiving public health care assistance. In 2005, MTM was kicked out of its home state of Missouri after it agreed to pay the state $2.4 million and forfeit more than $17 million in questionable billings to end an attorney general’s investigation into allegations of Medicaid fraud.
MTM was billing Missouri more than $40 million annually to manage medical transportation services for Medicaid recipients, including some who turned out to be deceased. A Missouri state auditor’s report suggested MTM was over-billing the state and being paid for rides that never occurred — and for some people who were deceased.
Since July 2004, MTM has received more than $19 million from the state of Minnesota. Their multimillion-dollar contract was expanded in June, despite public knowledge of their trouble in other states along with complaints of over billing and poor service here in Minnesota.
MTM contracts were also canceled in Pennsylvania and Ohio and the company is in trouble in Arkansas, Georgia and New York. What is this administration’s response? Expand MTM’s contract to 11 counties and put them in charge of all medical transportation with the intention to expand their contract statewide.
If a company like MTM, with a known history of fraudulent and questionable billing practices was able to land and keep a state contract, could there be other health providers defrauding taxpayers?
Let’s work together to find abuses that are going unchecked. Divisive election-year plans do little to move Minnesota forward.
Barb Goodwin, DFL-Columbia Heights, is a member of the Minnesota House who sits on the Health Policy and Finance Committee as well as the House Commerce Committee. She is not seeking re-election this fall.