Medicaid Apparently Wasted $500 Million

An audit released by State Auditor Suzanne Bump revealed the state’s Medicaid program squandered more than $500 million over a five-year period.

Bump called the sum the largest amount her office has uncovered in any audit in nearly 3 decades, October 2009 to last September.

The audit contended the state’s Mass Health program “unnecessarily spent” $223 million by paying medical providers directly when they should have been paid for by a so-called managed care organization or MCO instead.

The audit additionally found that the agency could have saved another $288 million it spent on services that were not required under contract but were often covered by MCO regardless.

We agree with Bump, to avoid paying for health service twice, Mass Health must know exactly what it should and should not be paying for and have a claims processing system that can follow those rules.

This amount of inefficiency needs to be corrected immediately.