States bolstering efforts to fight Medicaid waste, fraud in wake of GAO report

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Many state Medicaid programs are trying to improve their data analytics and provider education to curb fraud and waste within the program — efforts recently criticized in a federal report — one official said this week.

Dianne Hasselman, deputy executive director of the National Association of Medicaid Directors, told Bloomberg BNA that state Medicaid programs are “trying to have better quality data” and “greater transparency” but are still limited by less-than-ideal integrity reviews.

Hasselman also reported that as many as 34 states are currently incorporating waste and fraud oversight into provider education.

Her statements follow a report from the Government Accountability Office published Monday that called for the Centers for Medicare & Medicaid Services to improve how it shares states' best Medicaid integrity programs, as well as integrity reviews.

Staff limits within state programs — an issue touched upon in the GAO report — have also hampered efforts to improve integrity reviews, Hasselman shared.

“Medicaid directors are operating within a larger context, essentially running Fortune 50 companies, directing 25% of states' budgets in many cases, dealing with major changes in the landscape and health policy environment ... establishing new relationships with the CMS, evaluating value-based purchasing and negotiating million-dollar contracts,” she told Bloomberg. “Program integrity is just one part of what they're doing."