Medicaid “Loopholes” Need Fixed

Posted on Wednesday, September 16, 2015 8:51 AM

According to members of the House Energy and Commerce Health Subcommittee, legislation is needed to fix the “loopholes” in the Medicaid program that make it susceptible to fraud and abuse. Last week, the group discussed six bills aimed at closing Medicaid loopholes that allow people with significant resources to receive benefits. The goal of the proposal is to strengthen the overall integrity of the program. The bills discussed include the following:

  • The Ensuring Terminated Providers are Removed from Medicaid and CHIP Act, which addresses concerns that providers terminated from Medicaid in one state sometimes still participate in other states
  • Bill H.R. 1771, which would close a loophole identified by the Government Accountability Office that counts income from annuities of a community-dwelling spouse as income for an institutionalized spouse when determining Medicaid eligibility for long-term care services
  • The Medicaid and CHIP Territory Fraud Prevention Act, which would encourage territories to create Medicaid fraud prevention units

Due to the growth of the Medicaid program, the OIG believes it is critical to continue to conduct effective oversight to ensure that funds are spent appropriately. Four additional bills have also been drafted to improve the Medicaid program. Click here to read more.

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