HHS Reports Data Lacking in Medicaid Prevents Proper Oversight

As reported by Health Data Management:

“The lack of robust national Medicaid data is preventing the Centers for Medicare and Medicaid Services from preventing, detecting and addressing improper payments, which totaled nearly $37 billion in Fiscal Year 2017.

That was the message delivered to lawmakers on Wednesday by a senior official from the Department of Health and Human Services’ Office of Inspector General, who testified before the Senate Committee on Homeland Security and Government Affairs.

“A consistent impediment to effective prevention, detection and enforcement within the Medicaid program (is the) lack of complete, accurate and timely national Medicaid data,” testified Brian Ritchie, assistant inspector general for audit services at OIG. That shortcoming, hampers CMS in quickly identifying and addressing problems in the program, he adds.

Data from the Transformed Medicaid Statistical Information System (TMSIS) were supposed to help ensure the effective administration and oversight of the Medicaid program, including enhancing the ability to identify potential fraud, waste and abuse. While all states are now reporting to this national repository for Medicaid data, the data are not sufficient to provide effective oversight of the program, according to OIG.”

ANCOR has long recognized deficiencies in data in Medicaid and is addressing this with a proposed data bill. For members interested in joining the conversation, please contact Sarah Meek, Director of Legislative Affairs, at [email protected]