NewburyportNews.com, Newburyport, MA

Opinion

October 23, 2012

Audit shows fraud weaknesses in 'Romneycare'

It’s unfortunate to see that a state program aimed at helping the less fortunate has been exposed as a fraud free-for-all.

MassHealth is the Bay State’s version of Medicaid. State Auditor Suzanne Bump released an audit of MassHealth that found the program is losing millions of dollars to fraud.

That should be a warning to the rest of the nation, as it adopts our state’s “Romneycare” program. The Affordable Care Act, better known as “Obamacare,” is expected to funnel millions of the nation’s citizens into their states’ Medicaid plans. The level of fraud found here could be magnified across the country.

Thousands of out-of-state residents could be taking advantage of the program to provide health care benefits to low- and moderate-income individuals living in Massachusetts, according to the report.

Bump’s audit found that MassHealth fails to verify the residency of benefits recipients. The audit also found that others may be receiving benefits while not meeting income qualifications, the State House News Service reported.

The failure to maintain eligibility standards could be costing the state millions. MassHealth is an enormous program serving 1.3 million enrollees — or about one in five Massachusetts residents. In fiscal year 2011, the program paid health care providers more than $12.2 billion, of which 35 percent came from state funds. The program’s costs are growing on average 8.7 percent annually, Bump’s audit found.

Bump’s office found MassHealth does not verify an applicant’s state residency, relying solely on self-declaration, the State House News Service reported. MassHealth only checks someone’s address when there are conflicts in an applicant’s information. The policy leaves MassHealth vulnerable to fraud, according to the auditor’s report.

Given MassHealth’s weak eligibility standards, fraud is inevitable.

In 2010, MassHealth spent approximately $6.5 million on services for 4,643 individuals who were later removed from the program because they were not Massachusetts residents, received benefits from another state, or state officials could not determine where the enrollees lived, the news service reported.

Text Only | Photo Reprints

NDN Video
Guardians of the Galaxy (Trailer) Famous Internet Cats Help Big Cause With Viral Video Raw: Obama Gets Hug From Special Olympian Snoop Dogg Narrating Animal Footage Is Perfect Tigers Acquire David Price - @TheBuzzeronFOX Russell Brand Slams Sean Hannity Over Gaza Conflict Segment Chapter Two: Composing for a film in retirement Woman's Dive Goes Terribly Wrong Brian Williams Reports on Daughter Allison Williams' 'Peter Pan' Casting News Did Jimmy Fallon Look Up Heidi Klum's Dress? What Drama? Miranda Kerr Poses Topless Plane crashes in San Diego Costco parking lot Justin Bieber Takes To Instagram To Diss Orlando Bloom You Won't Believe the Celeb Cameos in "Sharknado 2" Pitch Invading Morons Cause Chaos - @TheBuzzeronFOX Orlando Bloom 'Takes a Swing' at Justin Bieber In Ibiza Sadie Doesn't Want Her Brother to Grow Up "Maxim" Hotness! See Jessica Alba's Sizzling Spread Two women barely avoid being hit by train Broken Water Main Floods UCLA
Special Features
NRA Waterfront Plans