Audit: Medicaid cuts unnecessary

Money could have paid for wheelchairs and other items, McCaskill says.
Tuesday, October 4, 2005 | 12:00 a.m. CDT; updated 6:44 p.m. CDT, Monday, July 14, 2008

JEFFERSON CITY — Missouri State Auditor Claire McCaskill says her office has found how nearly $5 million in the administration’s cuts to the state’s Medicaid budget could have been retained to recover the cost of items such as wheelchairs, oxygen devices and prosthetics for Medicaid recipients.

McCaskill said the audit conducted from Jan. 1, 2003, to March 31, 2004, found that the state could save

$5.4 million annually through competitively bidding for the purchases of such medical items, referred to as durable medical equipment.

“Competitive bidding is the best friend of the taxpayer in government services. It is a process by which you are sure you are getting the best value out of taxpayers’ dollars,” McCaskill said.

The state has not agreed to begin a bidding process for the equipment, McCaskill said.

Debra Scott, spokeswoman for the Missouri Social Services Department, said the state is looking at the competitive bidding process.

“That is a relatively new process. Only two states have competitively bid for durable medical equipment and did so under a waiver from the federal government,” Scott said.

McCaskill’s audit reported that 41 percent of the time, Missouri pays more than the average rate for medical equipment paid by surrounding states.

The audit cited one example in which a prosthetic device had a Missouri reimbursement rate of $2,440 while four of the eight surrounding states had a rate of $1,830 for the same device.

Additionally, McCaskill charged there is little encouragement to enforce a law that states that Missouri businesses should be favored if their service or product has the same quality and costs the same or lower. During the audit period,

$4.8 million has been paid to non-Missouri providers for the same items offered in Missouri.

The audit also reviewed the state’s system for transporting Medicaid recipients to nonemergency medical appointments.

McCaskill said auditors found that the Medicaid transportation contractor made a profit of $19 million more than the previous contractor during a 15-month period. She recommended the next contractor be better monitored to make certain that he or she is adequately documenting that all trips taken are for Medicaid purposes, using the most cost-effective transportation.

But Republican Gov. Matt Blunt’s office said the findings by McCaskill, a Democrat, were old news — based on procedures during the administration of Democratic Gov. Bob Holden.

“She’s working on very dated information,” spokesman Spence Jackson said. “We since canceled the contract that was costing us so much money that Bob Holden entered into.”

The audit cited one example in which the contractor charged the state for $98.44 in administrative services for a Medicaid recipient who drove himself to an appointment for 15 cents a mile for a 24-mile round trip.

Social Services officials said the audit information was old news.

“There are no surprises here,” Scott said. “Under Gov. Blunt’s administration, we have been aggressively pursuing reform and change in the Medicaid system, and non-emergency medical transportation and durable medical equipment are two very important pieces of that.”

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