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Straight talk from Mike Kiegerl: The Need for Medicaid Reform

Next to education Medicaid is the largest single expense in the Kansas budget. Those two items make up 80% of total state spending. Cost have been rising at double-digit rates during the past few years while fraud and abuse take an alarming share of every Medicaid dollar spent. I serve on the House/Senate Committee charged with addressing the problems the Kansas Medicaid program is facing and we held several weeks of hearings to do so. To begin with it must be understood that Medicaid insures the poorest of the poor, providing proper medical care to a special population, from small dependent children to the feeble old. The majority of funding comes from the federal government, the state pays little more than 40%. With the money from Washington come certain mandates, services which must be provided. Kansas has chosen to offer coverage or care beyond the Federal requirements. We were aced with two equally unpalatable choices to save costs: Tighten eligibility requirements and eliminate a umber of people now covered (this was done in Missouri) or limit coverage only to what is required under federal law. I determined early on that I could not support either solution, believing that we have a duty to take care of the weakest, the most vulnerable and defenseless amongst us. One area of great potential savings is the elimination of fraud and abuse. Testimony revealed that huge amounts of money are wasted on those who, by virtue of their own resources, are not eligible for Medicaid. There is also ample evidence of substantial provider fraud. Therefore the committee unanimously recommended and created a special position in the attorney generals office charged with investigating and prosecuting fraud. It is anticipated that conservatively estimating tens of millions dollars will be saved by this measure alone. It is hoped that this will improve the financial situation in the near term. The goal is to bring Medicaid spending under control without lowering the quality of care received by Medicaid patients. In the long term we\’ll need to find ways to involve the private sector health care providers to make to make Medicaid more patient friendly and less costly.

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