Banned Medicaid Providers Still Participate In Some State Programs, Report Finds
The health law requires that states terminate a health care provider from the health insurance program for low income people if another state dropped the provider for reasons such as fraud or quality problems. But about 12 percent of programs find a way to avoid this circumstance, the inspector general reports.
The Hill:
Banned Medicaid Providers Getting Around ObamaCare Rule
Some healthcare providers dropped by state Medicaid programs because of fraud or quality problems were still participating in other states’ programs, contrary to requirements in ObamaCare, according to an inspector general report. The Affordable Care Act requires that a state terminate a healthcare provider from Medicaid, the government health insurance program for the low income, if it is dropped for reasons like fraud or quality problems from a different state’s program. (Sullivan, 8/5)
Reuters:
Banned Medicaid Providers Still Participate In Some States, Report Says
Hundreds of medical providers banned from a Medicaid program in one state are able to take part in another state's program despite regulations designed to stop them, according to a report by an independent federal auditor to be released on Wednesday. The continued participation of banned providers leaves state Medicaid programs for the poor and disabled vulnerable to fraud, waste and abuse, according to the study, which says the problem reflects a struggle by states to communicate with one another. (Pell and Cooke, 8/5)
Modern Healthcare:
Providers Booted From State Medicaid Programs Still Drawing Funds From Other States
About 12% of providers kicked out of their state Medicaid programs for fraud, integrity or quality issues are still participating in other states' Medicaid programs, according to a report released Tuesday by HHS' Office of Inspector General. According to the report, 295 providers across the country who were terminated from their states' Medicaid programs for cause in 2011 were still billing other states' Medicaid programs in 2014. Under the Affordable Care Act, states are supposed to pull providers' from their Medicaid rolls if they've already been removed from another state's program for fraud, integrity or quality problems. (Schencker, 8/5)
