States hire consultants to increase their Medicaid reimbursements, need oversight

 News services (see, NYT and Reuters) report two-thirds of the states employ contingency-fee consultants to increase their Medicaid reimbursements, often using "questionable billing practices" and tactics. The findings are from a GAO study for Senator Charles E. Grassley, the Iowa Republican, chairman of the Finance Committee.

"Because of its size, complexity and federal-state structure, the Medicaid program has been subject to waste, abuse and exploitation," the GAO is reported to have stated. Federal oversight is recommended.

Medicaid Financing: States' Use of Contingency-Fee Consultants to Maximize Federal Reimbursements Highlights Need for Improved Federal Oversight GAO-05-748, June 28, 2005.
(available in PDF, 2.2MB, Abstract, and Highlights-PDF, from GAO)


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