Feds Wasted Nearly $12 Billion on People Not Eligible for Medicaid, Report Says


Tennessee clearly is not the only state in the nation that has a problem with wasting Medicaid money.

According to a new report from the U.S. Government Accountability office, the federal government wasted almost $12 billion taxpayer dollars on people who took Medicaid — but weren’t eligible.

“Undercover testing revealed three out of eight applications with incorrect Social Security numbers were getting approved,” according to the Memphis-based FOX 13.

“Not everyone who was ineligible and received coverage committed intentional fraud. Some didn’t qualify for Medicaid because of administrative issues like missing a deadline. A Senate committee was held this week to address the wasted funding for the Medicaid Program.”

As The Tennessee Star reported last month, Tennessee Comptrollers said staff members at two health care facilities in the state billed Medicaid for a lot more than legally allowed, and taxpayers lost money as a result.

In two separate audits, Comptrollers called out staff at The Bridge at Highland in Portland, Tenn. and Signature HealthCare of Putnam County in Cookeville.

As reported in August, Tennessee taxpayers lost more than $3 million after a corporate-run nursing facility billed the state that much money for expenses not covered under Medicaid.

That corporation, AltaCare, is based out of Alpharetta, Georgia.

As The Tennessee Star reported, employees at an Oak Ridge health care facility billed Medicaid more than $25,000 for items that Medicaid wasn’t supposed to cover.

As also reported that month, the Bureau of TennCare overpaid more than $600,000 to a now-closed health care clinic in Madisonville. Officials at this facility, the Women’s Wellness and Maternity Center, also over-reported nearly 5,000 paid TennCare visits.

These same officials also under-reported more than $50,000 in payments from managed care organizations, third parties, and patients, auditors wrote.

As reported in April, members of a Franklin-based facility, ProHealth Rural Services, Inc., allegedly committed fraud to get $6 million in TennCare benefits to which it was not entitled. Also, The Star reported last year, TennCare gave out more than $700,000 to duplicate members and to people who were already dead or incarcerated.

All those recipients were ineligible to receive TennCare money.

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Chris Butler is an investigative journalist at The Tennessee Star. Follow Chris on Facebook. Email tips to [email protected]






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