GAO report used as ammunition to challenge Medicaid spending

NEWS IN BRIEF — Posted Dec. 17, 2012

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Sen. Orrin Hatch (R, Utah), the ranking Republican on the Senate Finance Committee, called for structural reforms to Medicaid after the release of a federal report that found inconsistencies in the program’s expenditure data sets.

The Government Accountability Office assessed two sets of data on total Medicaid expenditures for fiscal 2007 through 2009. Researchers looked at CMS-64 data, which compute the federal government’s financial participation in each state Medicaid program, and Medicaid Statistical Information System data, which link expenditures to individual beneficiaries.

GAO discovered a $43 billion gap for fiscal year 2009 between the two sets of data, much of which was attributed to the differences in how each are designed. But even after adjusting for various factors such as disproportionate share hospital payments, prescription drug rebates, Medicaid health insurance payments and Medicare premiums, differences remained. That meant billions of dollars were left unaccounted for, according to the report.

The findings underscore the problems of expanding the program under the Affordable Care Act, said Hatch, who requested the report. “As demonstrated by the nonpartisan GAO, the Obama administration once again bit off more than they can chew and remains woefully unprepared for the largest expansion of Medicaid in history.”

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