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You are here: Home / Health / Medicine / Ending the ‘pay & chase’ method of combating Medicaid fraud

Ending the ‘pay & chase’ method of combating Medicaid fraud

February 11, 2015 By O. Kay Henderson

John Wills

John Wills

An Iowa House committee has unanimously approved a bill that would make it harder for Iowans to get government-funded health care when they’re not eligible.

The federal government has called on all states to speed up investigations of whether applicants for Medicaid coverage have assets and income that would make them ineligible for government health care coverage. Representative John Wills, a Republican from Spirit Lake, says if the bill becomes law, the state will contract with private companies to do the cross-checks.

“Currently what they do is they batch up 100 people at once and they submit those and it might take several days or a week and they send the results back,” Wills says. “This will be one person at a time, 12 to 24 ot maybe 48 hours at the most in order for a result to come back, so people are going to get their benefits must faster, but the income is going to be verified much faster as well.”

Representative Linda Miller, a Republican from Bettendorf, says states like Florida and Illinois have discovered about 17 percent of their Medicaid fraud and abuse cases involve people who’ve filed claims, got coverage, but were later judged to have too many assets to qualify.

“I don’t believe we’ll see that kind of savings,” Miller says. “But will there be some? Yes.”

She says doing a financial check quickly means the state isn’t caught in the current “pay and chase” system of awarding government-paid benefits to ineligible Iowans, then trying to recoup the money.

The legislation as originally drafted would have required speedy income vertification for other public assistance programs like food stamps and low income heating assistnace, but the version approved by the House Human Resources Committee on Tuesday afternoon just deals with Medicaid.

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Filed Under: Health / Medicine, News, Politics / Govt Tagged With: Democratic Party, Legislature, Republican Party

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