State Medicaid Directors Decline to Commit on Fraud Risk Reports at House Hearing

Directors of Medicaid programs in two states declined to commit during a congressional hearing to providing fraud risk assessment reports requested more than three months earlier. The committee chairman stated that one state had failed to provide certain information responsive to the committee's March 3 letter.

The letter had asked for documents on corrective actions to strengthen program integrity and records of how the state designates and evaluates provider risk levels.

The New York Medicaid director said the state had been as responsive as it could to multiple inquiries from the committee, the U.S. Centers for Medicare and Medicaid Services, and the inspector general's office within the U.S. Department of Health and Human Services.

The chairman noted that the state had not provided designated risk levels for Medicaid-only providers and had supplied only basic information on the frequency of on-site efforts. The director agreed that transparency is paramount but said he could not commit at the hearing and would take the request back.

m. the night before the hearing. The director cited 26,000 audits and investigations conducted over the past five years and said the state acknowledges the committee's frustration. The director added that ongoing law enforcement investigations could be impacted by the release of certain audits and that the state would provide appropriate information at the appropriate time.