State auditor questions Medicaid savings

The restructuring of the state’s Medicaid program was supposed to save Kentucky millions of dollars, but a new report by Kentucky State Auditor Crit Luallen questions whether retooling the state’s health-care program has led to real cost savings.

In a report released Monday, Luallen said savings of $120 million touted by former Gov. Ernie Fletcher could “not be substantiated because of inconsistent and confusing reporting practices.”

Luallen applauded the Department of Medicaid Services for trying to control the growth in spending for the program for poor and disabled Kentuckians, but she said, “this audit, coupled with recently disclosed $389 million Medicaid shortfall in the current year, underscores the need for transparency in Medicaid reporting.”

In 2007, the health-care program covered 711,000 people at a cost of $4.6 billion. When changes were made in the Medicaid program in 2006, officials said there would be savings of $120 million to $130 million a year and $1 billion over seven years.

But that information could not be substantiated, Luallen said

Medicaid submits reports to the legislature, but those reports are based on estimated savings, not budget amounts, the audit says.

There also is no means in the current reporting system for legislators to know whether the Medicaid program is working and whether some of the changes in the program are on target or working.

Luallen said that without accurate information, state legislators will not be able to make informed decisions regarding a health care system that is used by 17 percent of Kentucky and costs almost $5 billion a year to operate.

SEE TUESDAY'S HERALD-LEADER FOR MORE ON THIS STORY

- Beth Musgrave

Comments

Hey Crit....

Fletcher's out of office now. You can quit playing your partisan little games anytime now.

With the Cabinet for Health and Family Services; its just the tip of the iceberg of the malfesance going on.

[foolio]

How can savings in 2007, the year following the changes that "were made in the Medicaid program in 2006" even be evaluated? The year isn't over. Were the changes in place for fiscal year 2007?

And what were the inconsistencies? Is it because federal rules changed? Is it because the Patton/Hesen/LuAllen administration kept bad records?

Beth, I hope you paint a clearer picture in "Tuesday's Herald Leader", because all you say above is that there isn't any news to report...

[Elizabeth]

How does the new Governor plan on 1) holding the line on growth of Medicaid costs and 2) making sure reporting is consistent over time when the program has to be revamped so often to make sure it delivers promised coverage and stays within budget????

Are we going to make sure that all children have health coverage??

3:21: Please inform the rest of us what that malfeasance is so it can be stopped.

[John]

No news, just partisan politics!

"Critter" must've gotten tired of auditing Republican CJE's in the Old Fifth, so she's gonna take a few more pokes at the former administration.

Maybe Critter ought to audit Stumbo's office. Bet that'd be interesting.

Just another problem "Fletcher" left us to deal with that will mean casino gambling and/or increased taxes are a necessity. Just wait and see. And of course it won't be Beshears fault. It will be Ernie's! All of course solved with casinos coming to Ky! You would think that with all these financial problems coming out, the new governor would try to tighten up the budget and not give such huge salaries to his friends!!!

2007 is not over, the reforms have not been in place long, the paperwork has not been through the "process". The Auditor can't find proof of savings or overruns and the Dems on the oversight bodies say their is no "baseline" for comparasons of costs and services...sounds like the rationale for crying that we need casinos to make up the "shortfall".

You are telling me that there is no accounting of costs and services for the biggest federal program of them all?

Nonsense.

3:21 The Inspector General made a report which admitted that social workers were placing private citizens on the CAN database. This is a database which is to list child abusers so they cannot be employed in child care fields.

However, social workers are placing people on it for personal and political reasons. AND then, they violate that person's due process rights by not notifying the person.

So, you might even be listed on this CAN database and not know about it. The information is suppose to be confidential. However, it has been made available to state employees. All they have to do is to long and search for peoples names, even if their employement does not need access to the database.

Under Secretary Birdwhistell, the Cabinet knew that people were listed on CAN without getting due process; and did nothing about it. There's more. . . .

8:17 do tell, we want more.

12:03 Okay, whats going on with the Ombudsmen and the Administrative Hearing Office Branch; The Ombudsmen is rejecting many complaints by private citizens denying them administrative hearings even though they are within the timelines.

Then if the citizen is able to get administrative hearing; State and federal regulations along with Federal case law requires the Cabinet to issue a final order in 90 days.

It is my experience none of the administrative hearings, including CAPTA get completed within 90 days. It's generally 150 days. Commissioner Mark Washington knows he is violating state law, but he won't sign administrative hearings final order timely.

Just think about this; the whole administrative hearing branch is operating in violation to Constitutional rights. A federal court has said that orders must be done within 90 days to not violate due process.

Meanwhile, Wawshington, Emberton, and Birdwhistell did nothing about the violation of the 90 day law in the administrative branch while creating this mess in medicaid.

Then it comes back to this; Social workers can purposely falsify investigations against people and get away with it because even their Commissioner Mark Washington is also violating law. This is why the protectiong and permanecy has become so lawless.

[Lyndon Combs]

Step one in the preparations for a tax increase. I thought she was busy up here in Knott County busting us hillbillies.

[Kelsey]

I bet the State Auditors office will have to hire a great deal of new investigators due to all the Waste Fraud and Abuse they are finding in Frankfort now. First Transportation and now CHR. The word is that they are finding empty money bags,bugs etc in odd places in the Governors office. Money bags, bugs, secret doors this could be the making of a new movie. Kelsey.

8:17: From what I understand the CAN database, and how it is used, is mandated by both state and federal law.

I agree with you that there are plenty of abuses of the "investigation" process. Unfortunately the general prevailing opinion of the public, and thus their lawmakers, is that when it comes to abuse and neglect they "had better err on the side of the child". That, of course, may violate constitutional protections for the adult. A social worker and her/his supervisor can decide if someone has abused/neglected a child. It costs a lot of money for an attorney to prove your innocence. Until that time you can be denied employment.

Unfair? Yes. But is it the law? Yes, it is.

This is something that you have to change through the legislature.

It is obvious you have suffered. Turn that into something for the good.

6:39 The point is that social workers are actually violating the law as it is written. The social workers are suppose to send the person a certified letter before the person name is placed on the CAN database. The social workers are not doing that because they know they have no reason to substantiate the abuse.

Commissioner Mark Washington and Secretary Birdwhistell know all about this and have done nothing. In fact, what they have done is to cover it up.

And the public does not know about the CAN database. The people I have explained it to are very upset that a social worker and their supervisor can administratively convict a person of child abuse without giving the person a criminal trial.

8:58: I, of course, don't know the details of your case and just hope you have a good lawyer (they are hard to find) and can come up with the money to pay him/her.

This is a matter of state law and its interpretation in state regulations. If it is wrong, work to get it changed.