The Government Accountability Office recently issued a pair of reports within days of one another critical of how the Medicaid program gathers data and screens its provider participants.
Medicaid, by far, is the leading source of payment for long-term care services in the U.S.
Inaccurate, incomplete and often tardy data hampers program oversight, the GAO found in a report issued Feb. 6
Source: GAO reports assail Medicaid oversight, provider vetting – McKnight’s Long Term Care News
Seems all this mess is a Medicaid internal affairs. Providers should not expose them self to this denigrating lack of respect , abuse and harassment by third parties, corporates, and MCO , in a way providers could be blamed by the inefficient Medicaid means to control their own affairs that assails Medicaid oversight.
Provider still the Guinea pigs. The only legal requirement for being provider is having a dental license. A license without a red flag with the state board is to be good enough.
Seems the solution is of how Medicaid , select, screen and trainee their own employees. How get enough budget for the beneficiaries want to cover. And how implement MCOs responsibilities.
Providers are not to be vetting. Any applicant provider with a valid licensed in good status with the state board should be accepted by Medicaid. It happen before. The state board has open access to check providers licenses for third parties. The licenses gives right of practice which include medically necessity assessment.
We have seen so far Medicaid fraud is a legal issue that should be address in courts\’ with legal claims. No by harassing providers with suspicious speculations without legal judgments to prevent fraud.