No surprise that S.C. Medicaid makes big boo-boos
Unfortunately, it isn’t surprising to learn that S.C. Medicaid data misidentified doctors as having abused the system. Indeed, repeated widespread inaccuracies in Medicaid programs across the nation have prompted the federal government to search out and address costly problems related to them.
But what is surprising, and galling, is that the S.C. Department of Health and Human Services tried to shift the blame.
The agency actually said the problem stemmed from Sen. Charles Grassley, R-Iowa, asking “the wrong questions” as part of his investigation into Medicaid’s drug-prescription program.
But the senator’s questions weren’t wrong.
The state agency’s answers were.
The DHHS blamed its outdated management system for unfairly and inaccurately holding three psychiatrists up for embarrassment.
But agency staffers were well aware of system inadequacies. The department has requested $350,000 from the state to update its system.
The investigation pointed to 31 South Carolina cases in which Medicaid funds were abused or overpayments were made. That is hardly a daunting number.
In light of system shortcomings, staff easily could have reviewed 31 original case records and spared doctors this ugly experience.
To her credit, Kathleen Snider, bureau chief of compliance and performance review for DHHS, admitted that she should have done just that.
But it isn’t just this incident which should concern taxpayers.
The debacle raises an alarming question: If it was so easy to cast aspersions on people who were not guilty of overcharging Medicaid, why shouldn’t we suspect that people who are doing so are getting away with it?
Until Medicaid, Medicare and other entitlement programs are reined in to a reasonable level — including major reductions of fraud and mismanagement — the nation’s entitlement-funding crisis can’t be effectively addressed.
Every state, including South Carolina, needs to be extremely diligent in handling Medicaid dollars to ensure that they provide care for those poor and disabled who need it most — and so that the taxpayers can feel confident that their dollars are being managed honestly and professionally.