Today, Congresswoman Michele Bachmann (MN-06) addressed the House Oversight and Government Reform Committee’s Subcommittee on Government Organization, Efficiency and Financial Management hearing titled “Assessing Medicare and Medicaid Program Integrity.”

Bachmann provided a statement (below) about her concerns surrounding payments within Minnesota’s Medicaid program. Bachmann concluded her remarks by announcing that she is calling on CMS for an immediate, independent third-party audit of Minnesota’s managed care Medicaid program (see letter below).

Bachmann's statement as prepared for delivery:

Chairman Platts, Ranking Member Towns, and Committee Members, thank you for your attention to the critical condition of Medicaid's program integrity.

In April, I testified in a joint hearing of two Oversight Committee subcommittees on the complete lack of reporting, collection, and verification of meaningful data in Medicaid. The staff report from that hearing stated, “Minnesota provides a stunning example of how states are failing to properly ensure the appropriate use of taxpayer dollars spent on Medicaid managed care.”

In order for states to ensure the appropriate use of taxpayer dollars, they must be able and willing to collect the data that shows how much is paid in a claim, for what, and to whom. Since the investigation into Minnesota Medicaid fraud has unfolded, several implicated parties have begun to offer up excuses. According to the trade organization for the managed care organizations, the Department of Human Services (DHS) actually has the data but not the ability to analyze it. They say the state’s computer system is too antiquated.

But in contradiction to this, a DHS Assistant Commissioner said that the data “is literally analyzed by DHS on a daily basis, and has been for years.”

Now either the trade association representing the health plans is fudging, or DHS is.

It’s our job to immediately get to the bottom of this. CMS is already tasked with identifying patterns or instances of fraud and abuse in Medicare and Medicaid, but despite that, they are requiring no documented data.

This month I am introducing a bill that will hold CMS accountable to ensure stated audits are conducted properly.

But because this situation needs immediate attention, I am proud to announce that I am sending a letter today to CMS, calling for an immediate, third-party independent audit of Minnesota’s books.

We cannot allow taxpayer dollars to flow without proper record keeping ever again.

Thank you again to the committee and I yield back.

The letter to CMS is as follows:

Dear Administrator Tavenner:

On April 25, 2012, two subcommittees of the House Oversight and Government Reform Committee held a joint hearing titled, “Is Government Adequately Protecting Taxpayers From Medicaid Fraud?” Based on the conflicting testimony of Minnesota Health Commissioner Lucinda Jesson to earlier statements, the General Accounting Office assessment of CMS’ lack of oversight, and allegations of cross-subsidizing of non-qualified state plans with Medicaid dollars, I am calling for an immediate, independent Medicaid Integrity Contractor audit, consistent with Federal Government Auditing Standards, of Minnesota’s managed care Medicaid program.

The Medicaid Integrity Program was created under Section 1936 of the Deficit Reduction Act of 2005, and the Patient Protection and Affordable Care Act expanded the Recovery Audit Contractor Program to include Medicaid in an attempt to better identify and recover improper and fraudulent payments. Therefore, I am confident that CMS has the infrastructure and the funding to immediately facilitate this audit.

The staff report from the aforementioned committee hearing states, “Minnesota provides a stunning example of how states are failing to properly ensure the appropriate use of taxpayer dollars spent on Medicaid managed care.” I hope that Minnesota’s Medicaid Integrity Contractor audit will also provide a stellar example to other states of proper data collection and reporting. I anticipate your response.

Sincerely,
Michele Bachmann
Member of Congress

Bachmann also is introducing legislation this month that will require independent, third-party audits of all states.

Watch video of Bachmann's statement here.

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