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House Urges End to Medicaid Fraud

November 9, 1999

WASHINGTON (AP) _ The fight against $17 billion in annual Medicaid fraud and abuse is hampered by antiquated computers, complex criminal schemes and an unwieldy program administered by 50 state governments, state and local officials said Tuesday.

``You’re running 50 different programs. This program will always be vulnerable, in my opinion,″ Leslie Aronovitz, director of the Chicago field office of the congressional General Accounting Office, told a House hearing.

Rep. Richard Burr, R-N.C., told the witnesses that it’s time to stop endless government reviews and start solving the growing fraud and abuse problem in the medical program for low-income Americans.

``We don’t need to review it any more, we need to find a solution,″ he said.

Ms. Aronovitz said the idea of overhauling Medicaid to end fraud is something ``we haven’t really looked into with any depth.″

Saying he was using the General Accounting Office’s ``conservative″ estimate, subcommittee Chairman Fred Upton, R-Mich., said, ``Medicaid may have lost $17 billion to fraud and abuse during fiscal year 1998. No one knows precisely how much fraud has actually cost the Medicaid program, however, although many experts believe the number may be far higher.″

Marc P. Fecteau, president of the National Association of Surveillance Officials, said states are trying to combat Medicaid fraud and waste with 20-year-old computer systems that are ``the dinosaurs of technology.″

The obsolete technology is combined with a serious shortage of state investigators, Fecteau said. His organization is composed of state officials responsible for monitoring Medicaid for fraud, waste and abuse.

Officials told the hearing that Medicaid scams often cross state lines. Ms. Aronovitz said the effort involves ``a number of federal, state and local agencies that may have different or competing priorities in their efforts to investigate, prosecute and enforce compliance.″

Medicare is a federal health care insurance program for people 65 and older and for the disabled. Medicaid is a federal-state program that helps pay for health care for the needy, elderly, blind and disabled and for low-income families with children.

Fecteau said Congress has funded hundreds of positions for the FBI and inspector general offices to battle Medicare fraud, but the state agencies fighting wrongdoing in Medicaid haven’t received the same commitment.

``In an age where technological obsolescence is measured in days, our 20-year-old systems are definitely the dinosaurs of technology,″ he said. ``But then, as some states have reported, enhancing software technology to identify more cases without addressing proper staffing requirements simply results in more cases pending review.″

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