Be Very Medicaid Fraudulently Quiet

In an editorial posted October 22, 2009, the Michigan Department of Community Health Director, Janet Olszweski, drastically failed to identify numerous key issues, outside of “efforts to leverage federal funding” as to why the state is challenged in meeting the needs of the people.

Ms. Olszweski has failed to identify herself as the State Medicaid Director. The role of the State Medicaid Director is to establish policy under the guidance and clarification from the U.S. Department of Health and Human Services (DHHS) Centers for Medicare and Medicaid Services (CMS). Unfortunately, she has neglected to address Medicaid policy in dealing with fraud, waste and abuse.

Senator Kahn recently introduced SB 942 calling for the creation of a State Medicaid Inspector General to open discussions surrounding Auditor General reports documenting evidence of over $1 billion in Medicaid fraud, waste and abuse.

As it stands, the state is in a position of a future decrease in the Federal Funding Percentage, meaning it will loose even more federal dollars. The program’s funding levels have remained stagnant since 2000 because the state is not in compliance with federal funding mandates.

Olszewski may place the state in a precarious position if she were to raise the issue of Medicaid fraud, waste and abuse because the Michigan Medicaid Fraud Unit, housed in the Department of Attorney General and funded DHHS, does absolutely no activities in prosecution and recovery of Medicaid fraud, waste and abuse in child welfare, as it would be an inherent conflict of interest: the Attorney General cannot prosecute itself.

In essence, if the State Medicaid Director even whispered one word regarding the issue of Medicaid fraud, Michigan would be faced with even more substantial cuts in federal funding or possible federal receivership.

There is funding for program services and the opportunity for even more and efficient servicing will only come once the state takes a mea culpa stance for dropping the ball on accountability and transparency, because it never refers violations of federal and state law in Medicaid funded programs to the Attorney General.

Until the state implements policy for contractual debarment, revocation, sanctions and prosecution for recovery of funds in dealing with Medicaid fraud, waste and abuse, the only recourse for the existence of Medicaid funded programming will be through begging and taxing, at the expense of our most vulnerable populations.