Can CMS Encourage States To End Medicaid Fraud?

There seems to be major possible implications here on how the nation views child abuse and neglect, but then again, this could just a cursory assessment.

With almost all states reporting most recent data,it shows 59% of child maltreatment cases are neglect.

Traditionally, poverty has been codified by the States as neglect, leading to a distorted perception in actual intentionally perpetrated harms. As poverty increases, there is a direct and parallel relationship in the increase of child neglect cases. David G. Gil, a pioneer in the constructing the relationship between poverty and child abuse, was the streamlining catalyst for the States to generate policies to qualify for the funding of Child Abuse Prevention Treatment Act(CAPTA) programs.

CAPTA, being an entitlement program, established eligibility criteria based on meeting the Social Security Title IV-A poverty means test. Simply put, one must be impoverished to qualify for child welfare programming.

In the wake of the nation's economic challenges, factors such as unemployment, have led to an increase demand in social assistance. Since social assistance program funding has been shifted to child welfare, the only opportunity for assistance in the realms of keeping children in the community, as opposed to removals, and providing human assistance to meet basic living requirements (i.e. affordable housing, transportation, education, medical) has been through entrance of foster care.

These new Medicaid guidelines and waivers present States with opportunities to shift social philosophies from the criminalization of poverty to the promotion and securing of the general welfare of the nation by the amelioration of fraud in child welfare.

Louisiana has launched an new approach to combating Medicaid fraud, waste and abuse. Perhaps the new CMS guidelines can accentuate the Louisiana initiatives. I will be monitoring this national pilot program to stop Medicaid fraud. It is my belief that Louisiana's initiatives may prove effective in the realms of improving child welfare Targeted Case Management compliance and reducing unnecessary state placements of children out of the home.

It will be most interesting to observe the activities of the Louisiana Attorney General Medicaid Fraud Control Unit.

Guidance Letter to States Medicaid Director