House panel advances legislation to extend Medicaid task force review

A state commission tasked with rooting out Medicaid fraud is on track for a yearlong extension after a bill delaying its expiration passed through the House Health and Welfare Committee Wednesday.

House Bill 156 by task force member Rep. Tony Bacala, R-Prairieville, would allow the Task Force on Coordination of Medicaid Fraud Detection and Prevention Initiatives to continue operating through 2019. The commission was founded by the Legislature in the 2017 regular session to coordinate Medicaid fraud detection efforts and identify system-wide concerns.

Bacala said the task force has made strides but there is still more to understand about the state’s Medicaid health care program.

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“I think overall it’s working in a positive manner, with everything else you can be positive, but there are still little items we need to tweak or look at,” Bacala said.

Federal funds support more than 80 percent of the state’s Medicaid budget, but state agencies are responsible for execution and oversight of the program. The state expanded its Medicaid program under the federal Affordable Care Act in July 2016, extending care to over 450,000 mostly working poor families in the state.

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The expansion broadened eligibility to include families with annual incomes under 138 percent of the federal poverty level, about $16,764 for a single person and $34,644 for a family of four. Concerns over mismanaged funds have risen as more households join the Medicaid rolls and state budget issues drag on.

Suspected Medicaid fraud and abuse has been a hot topic among House Republicans in the last year, and was the focus of several spending reform proposals in the first 2018 special legislative session.

Six House bills related to Medicaid eligibility and fraud were brought in the special session, including a bill by Bacala allowing the Department of Revenue to release individual’s state income tax returns to the legislative auditor to determine Medicaid eligibility. Bacala has a similar bill filed for this regular session.

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Bacala said strengthening Medicaid pharmacy controls, assessing the requirements for diagnostic groups and streamlining the fraud detection efforts of managed care organizations are continued priorities moving forward. He said the Department of Health and Hospitals plans to issue changes to diagnostic providers as early as Jan. 1.

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