Medicaid
is
now
the
fastest-growing
expense
for
most
states,
oftentimes
crowding
out
funding
for
education
and
social
services.
CMS
Administrator
Dr.
Mehmet
Oz
drew
attention
to
this
during
a
talk
this
week
at
Sanford
Health’s
Annual
Summit
on
the
Future
of
Rural
Health
Care
in
Sioux
Falls,
South
Dakota.
He
noted
that
federal
Medicaid
spending
has
increased
by
50%
over
the
past
five
years,
with
much
of
this
being
tied
to
pandemic-era
policies
that
weren’t
rolled
back.
From
Dr.
Oz’s
perspective,
this
presents
opportunities
for
states
and
providers
to
“game”
the
system.
“Certainly
the
legalized
money
laundering
from
state-directed
payments
and
provider
taxes,
no
matter
what
you
might
think
about
them,
don’t
align
with
the
federal
government
and
with
state
governments.
They
do
quite
the
opposite.
It
was
a
grab
bag,
and
states
could
take
as
much
as
they
could
from
the
federal
government.
Oftentimes,
states
were
different
in
their
capabilities,
so
some
states
took
a
lot,
and
others
didn’t,”
he
remarked.
Essentially,
Dr.
Oz
is
criticizing
Medicaid’s
financing
mechanism
that
allows
states
to
draw
down
extra
federal
funds.
Many
states
levy
taxes
on
hospitals,
nursing
homes
and
other
healthcare
providers
—
and
then
use
that
revenue,
along
with
state-directed
payments,
to
trigger
additional
Medicaid
matching
funds
from
the
federal
government,
he
said.
During
his
address,
Dr.
Oz
also
said
that
fraud
in
the
Medicaid
and
Medicare
programs
is
abundant.
To
combat
this
fraud,
he
said
CMS
is
now
focusing
on
tracking
the
flow
of
money
rather
than
pursuing
individual
bad
actors.
“We’re
actually
chasing
the
money
now,
not
the
person.
And
we
have
joined
initiatives
with
the
Treasury
and
DOJ
to
address
some
of
these
issues
that
you’ll
be
hearing
more
about.
We
have
already
stopped
about
$4
billion
from
leaving
the
building
by
using
these
kinds
of
tactics,”
he
stated.
Overall,
Dr.
Oz
said
that
CMS
is
committed
to
working
with
other
departments
to
recover
misappropriated
funds
and
shut
down
schemes
that
exploit
systemic
loopholes.
He
believes
this
strategy
allows
the
government
to
act
more
quickly
and
effectively,
ensuring
that
federal
health
dollars
reach
the
patients
and
programs
they
were
intended
to
serve.
“We
have
to
go
after
these
programs,
come
up
with
clever
ideas
to
help
the
good
people
who
are
trying
to
do
the
right
thing,
and
separate
the
wheat
from
the
chaff
—
from
folks
who
are
defrauding
the
country,
and
by
doing
that,
aggressively
change
the
incentives
around
some
of
these
businesses,”
Dr.
Oz.
declared.
In
his
eyes,
this
tightening
of
oversight
and
alignment
of
incentives
within
CMS
will
redirect
billions
of
dollars
toward
more
legitimate
care
delivery
efforts.
Photo:
Sanford
Health