D S S   P R E S S   R E L E A S E

For Immediate Release:
June 8, 2005

Contact: Deborah Scott
(573) 751-4815

Governor's Push to Detect Medicaid Fraud
Saves $3 Million since January

Jefferson City - Governor Matt Blunt's emphasis on rooting out waste, fraud and abuse and demanding efficiency in government is already paying big dividends. Immediately upon taking office, the Governor directed cabinet officials to identify ways to improve efficiency and focused his top executives on the identification of waste, fraud and abuse. The efforts have already saved another $3 million in the Medicaid program.

"Since January, we have implemented a new state of the art Fraud and Abuse Detection system to monitor Medicaid billings. The amount saved through recovery and cost avoidance totals nearly $3 million," Blunt said. "This is a great outcome, and only the beginning. Numerous additional strategies are being implemented that will detect duplicate billing, over billing or inaccurate billing. We are going to see even greater savings in hard earned tax dollars," said the Governor.

The Medicaid Program Integrity Unit is working with a private contractor, Thomson Medstat, to strategically focus recovery efforts to maximize results. Sophisticated computer algorithms are being developed to detect billings that are outside the norm for a given service. Those claims are reviewed for accuracy. "The new system is definitely improving our ability to ensure that claims and payments are accurate," said Department of Social Services Director, Gary Sherman. "We are excited about what the grand total may look like by this time next year with the addition of new programming."