Medicaid services cost Missourians millions of dollars each year to provide necessary attention for those unable to provide the finances for themselves. One small portion of the Medicaid program involves "personal care services" intended to allow 37,000 elderly or disabled Missourians to remain in their own homes rather than move to nursing homes.
A new state audit of that program shows that identical services in St. Louis and Kansas City are costing the state twice the amount that is being charged in outstate Missouri. The difference, which is hard to explain, involves the amount of time spent for identical services in the urban areas as opposed to the rural areas.
For example, the audit found that achieving a given level of care took 24 hours of service in St. Joseph but 63 hours in St. Louis. That obviously illustrates a lack of oversight in the program. Past efforts to reduce the abuse in St. Louis resulted in an 18 percent reduction in authorized hours in that urban setting.
In short, the audit said that the Medicaid-managed care system was inadequately monitored. It called management of the program "weak."
"Medicaid officials cannot measure the utilization of covered services provided to managed care recipients and do not know if the state's total costs truly measured health care costs," the report concluded.
The audit found that Medicaid officials were not giving sufficient priority to monitoring accurate claims and were not watching for potential fraud.
And thus we have yet another example for those who believe we have ample programs to provide for the needy but we lack sufficient safeguards that taxpayer dollars are indeed being spent fairly and accurately. It's hard to argue for more taxes on the state level until all forms of abuse are addressed.