Report: Medicaid, Private Option serving out-of-staters, dead

by The City Wire staff ([email protected]) 124 views 

The traditional Medicaid and private option programs are providing benefits to people whose best addresses are out of state, who never seemed to have lived in Arkansas, or who are no longer living at all, according to a report prepared by a consultant hired by legislators.

In a report provided to legislators Monday and released to the public Wednesday (Oct. 7), The Stephen Group consulting firm reported that the Medicaid system is paying for benefits for 42,891 beneficiaries whose best address according to a LexisNexis search is out of state. That’s almost 16% of beneficiaries.

According to the report, 22,781 traditional Medicaid recipients and 20,110 private option beneficiaries have best addresses that are out of state. Among traditional Medicaid recipients, 4,137 have best addresses in Texas, and 1,896 have best addresses in California. Among private option recipients, 3,750 have Texas addresses while 1,324 have California addresses.

Meanwhile, 3,543 traditional Medicaid recipients have no record of living in Arkansas, while 3,210 private option recipients have no record of living in Arkansas. John Stephen with The Stephen Group told legislators that it’s possible some enrollees whose addresses are out of state actually do live in Arkansas.

The Stephen Group found 367 traditional Medicaid recipients who were deceased prior to being authorized – 261 of them for more than two years. Moreover, 128 private option recipients were deceased prior to being authorized, including 82 who had been dead for more than two years.

A LexisNexis search found 12,622 participants with property values exceeding $100,000. One Medicaid recipient had purchased a $419,000 property in Florida, while another had purchased a $749,900 property in New Jersey.

Sen. Bryan King, R-Green Forest, a private option opponent, said Arkansans have been deceived about the program’s problems.

“They put out statistics of every county enrollees in the private option. Have you seen one report that they’ve produced that shows 1,300 people in California?” he said.

He later added, “As I’ve said before, they’ve lied and kept it covered up because every month they put out per-county enrollees. … I mean, how innovative is it to sign dead people up on free health care?”

The Health Reform Legislative Task Force has been meeting this year to consider changes to the state’s overall health care system, particularly the private option, which uses Medicaid dollars to purchase private insurance for Arkansans whose incomes are below 138% of the federal poverty line. It was created by law in the 2013 legislative session. Gov. Asa Hutchinson asked legislators to fund the controversial private option through fiscal year 2016 at the same time the task force would be considering health care reforms.

The task force by law will present its recommendations in a report due by Dec. 31. It will continue to meet next year to oversee implementation.