In Brief: Missouri Collects $50 Million Through Fraud Enforcement; Michigan Urged To Adopt Health Insurance Exchange
Missouri Collects $50 Million Through Medicaid Fraud Efforts
Missouri Attorney General Chris Koster said this week his office collected more than $50 million during 2012 in pursuit of Medicaid fraud.
Altogether, Koster's office closed 21 criminal and 29 civil cases, leading to prison time for three people.
“Our criminal prosecutions and our large monetary recoveries serve as a warning to providers who would consider submitting false bills to Medicaid: we are watching, and you will not get away with it,” Koster said. “My office is committed to aggressively pursuing medical and home healthcare providers who are stealing from the taxpayers of Missouri by committing Medicaid fraud.”
According to data from the U.S. Department of Health and Human Services, Missouri's fraud unit collected $24.76 for every dollar it spent for investigations.
Aetna Selling Missouri Medicaid Business
Hartford, Conn.-based Aetna is selling its Missouri Medicaid business to Tampa, Fla.-based WellCare for an undisclosed sum.
The sale of Missouri Care is subject to regulatory approval. Altogether, the plan has about 100,000 enrollees in the central, eastern and the western portion of the state. Missouri Care's senior management will remain in place.
Aeta is shedding Missouri Care due to its pending purchase of Coventry Health Care, which includes a subsidiary Medicaid plan that also operates in Missouri called Health Care USA and has about 250,000 enrollees. Since Missouri caps Medicaid enrollments in commercial heath plans, Aetna had to reduce its number of Medicaid enrollees in order to remain in compliance with that rule.
Michigan Business Group Urges Action On Exchange
Although opposed to the Patient Protection and Affordable Care Act, the Michigan Business and Professional Association urged that state's Legislature to appropriate $30 million in federal to create a jointly operated state-federal health insurance exchange.
“Although we did not support passage of the Affordable Care Act, we believe it is critical that our state has as much input as possible into the creation of the health care marketplace in order to retain at least some control over what happens with health care in Michigan,” said MBPA Chief Executive Officer Jennifer Kluge. “If we do not at least begin the process, we will be forced to accept a health care exchange program created solely by the federal government without any input on behalf of our citizens and the business community.”
Gov Rick Snyder, a Republican, has been generally cool to reform, although he has said he supports a jointly operated exchange. However, he and other state officials have not reached consensus on which direction to go. The deadline for submitting a decision to the feds is Feb. 15.
