Hawaii’s Medicaid Fraud Unit Costs 10 Times What It Recovers

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Hawaii’s Medicaid Fraud Control Unit is costing 10 times as much to operate as it is in exposing waste, fraud and abuse in the federal health care program for the poor and disadvantaged, according to a new report from the Department of Health and Human Services’ Office of Inspector General.

The state of Hawaii government’s federally funded Medicaid Fraud Control Unit has no auditor, no written employee policies and no professional training program. The unit recovered about $337,000 from 2011 through 2013, but it spent $3.9 million during the same period.

“On the basis of our findings, OIG is concerned about the unit’s ability to carry out its statutory functions and meet program requirements,” the inspector general said.

Hawaii had fewer investigations, indictments, charges and criminal convictions than almost any other state in fiscal year 2014, according to a previous review from the inspector general.

Each state has a Medicaid Fraud Control Unit, funded largely by the federal government, but operating under the state’s attorney general.

Hawaii’s previous three biggest fails include:

1. When Hawaii’s State Obamacare Exchange Failed.

Hawaii’s state-run Obamacare exchange shut its doors in May after receiving $205 million in federal grants. It cost at least $5,100 for each of the estimated 40,000 people who lost coverage to switch to health care through the federal exchange.

State officials claimed they lacked sufficient funds to keep the Hawaii exchange operating. The exchange’s web site had experienced numerous technical problems.

2. When Hawaii’s Health Department Hoarded Money For Clean Drinking Water

Hawaii is still hoarding about $100 million in state and federal grants meant for safe, clean drinking water, according to a recent Environmental Protection Agency Office of Inspector General report.

The IG said the EPA shouldn’t give Hawaii any more funds for drinking water infrastructure until Hawaii spends the money it already has.

3. When a Hawaii VA Supervisor Manipulated Veteran Wait-Time Data

A U.S. Department of Veterans Affairs supervisor in Honolulu altered data to make it look like veterans had shorter wait times for benefits, according to a March report from the VA Inspector General.

The supervisor manipulated data to improve the appearance of his team’s progress amid national concerns about the VA’s treatment of veterans. The supervisor in question was allowed to resign, the report said.

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