Document: 15 states use "dubious" Medicaid accounting tactics

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Alabama, Alaska, Georgia and Illinois are among nine states that are listed as "potential" users of questionable accounting tactics to receive more federal matching Medicaid funds for nursing home care, according to a government document obtained by a news service.

CQ HealthBeat, which obtained the document, reported that the Health and Human Services Department is using it in its crackdown on dubious Medicaid accounting tactics. Iowa, Minnesota, North Dakota, Tennessee and Virginia are the other states that the Bush administration says had used improper accounting techniques for nursing home reimbursements, the New York Times reported today.

The administration also said six other states are accused of questionable accounting techniques to fund other types of care. Twenty states were said to have ended at least some of the objectionable accounting practices, according to the New York Times account.

State officials defended their practices, saying that in some cases, federal officials had actually approved some of the methods now being criticized. Some of the states had asked for clarification but received none, they also claimed.

The government could save $60 billion in Medicaid spending by curbing accounting tactics used by states, Michael Leavitt, HHS secretary, said in February. While critics say states improperly inflate their Medicaid funding to receive more federal matching funds, states deny the practice is illegal.