Daines: 'Sad Reality' $36 Billion in Medicaid 'Lost' to 'Waste, Fraud, Abuse'

Sen. Steve Daines (R-MT) said during a hearing Wednesday that the federal government has wasted $36 billion in 2018 due to “waste, fraud, and abuse.”

Sen. Daines spoke during a Senate Finance Committee hearing Wednesday on complying with Medicaid eligibility. The Montana Republican senator noted that the federal government loses tens of billions of dollars every year due to waste, fraud, and abuse.

According to a Montana state legislature audit, Montana is very at risk for Medicaid abuse and fraud due to a number of the state government’s lax compliance policies.

Sen. Daines said during the hearing:

One of the most fundamental responsibilities that we have as United States senators is to uphold the integrity of how taxpayer dollars are spent. As we’ve heard today, the federal government improperly spends over $36 billion in the Medicaid program in fiscal year 2018. The sad reality is that every single one of those dollars that is lost due to waste, fraud, and abuse means a lost investment in improving the health and well-being of vulnerable Montanans.

Montana is only one of seven states that does not verify income data before enrollment. The state also relies on the Obamacare exchange website to determine eligibility, which means that often, many Americans Obamacare qualify for Medicaid when they are truly not eligible.

“In 2018, a performance evaluation that was done by the Montana legislative audit division had a sample of 100 cases, it showed income errors in self-attested income in 24 percent of cases, that’s in one-in-four,” Sen. Daines noted during the hearing.

“The discrepancies were not resolved,” he added.

Brian Ritchie, the assistant inspector general for audit services at the Department of Health and Human Services, noted that the Centers for Medicare and Medicaid (CMS)

…allows too much latitude in the verification plans and doesn’t require things like the use of tax data, doesn’t require frequent wage checks, and those types of things.

Some lawmakers have proposed using contractors to rein in waste, fraud, and abuse in Medicaid.

Rep. Buddy Carter (R-GA) in 2018 told Breitbart News that his legislation, the Freedom to Use Contracted Entities Act, would allow private contractors to make eligibility determinations on behalf of state Medicaid programs – an idea that could have far-reaching implications for cutting waste, fraud, and abuse throughout federal and state bureaucracies.

States such as Illinois have hired private contractors, which has allowed the state to save hundreds of millions of dollars by cutting out Medicaid fraud and abuse.

Illinois hired private contractors to find waste, fraud, and abuse in its state Medicaid program; they disenrolled roughly 700,000 fraudulent Medicaid recipients. Based upon projections from Illinois policy, taxpayers could save between $390 t0 $430 million per year, with even greater savings over time.

“Our constituents want us to cut out waste, fraud, and abuse,” Carter said.