Vincent Gray: Investigate Medicaid

Washington, D.C. (Map, News) - District Council Chairman Vincent Gray is calling for a review of the city's troubled Medicaid program, which auditors say costs the city tens of millions in wasted dollars and threatens D.C.'s fiscal health.

In an exclusive interview with The Examiner, Gray said he wanted the city's health care bureaucracy thoroughly examined by investigators to determine exactly where the waste, fraud and abuse lie.

"This may be a wonderful opportunity for some kind of forensic audit," said Gray, who used to run the city's human services department. "Let's look at everything in Medicaid."

As first reported by The Examiner, an outside audit firm revealed last week that the D.C. Medicaid program posed a risk to the city's bond rating.

Medicaid is a federally funded program that subsidizes health care for the poor. Yet a host of inspections and reviews have found that D.C. officials routinely violated local and federal rules on open contracting, lost track of millions of dollars and lost out on federal payments of tens of millions more by not filing the right paperwork.

Waste has also been a persistent problem for the agency. This summer, the D.C Inspector General said city health officials overpaid health care providers to the tune of $97 million for services patients may have never received.

In their management response to last week's outside audit, health department officials who were primarily responsible for Medicaid billing said they were taking steps to improve the program. But Gray said it wasn't enough.

According to D.C. records, the city health department received more than $1 billion in federal grants in fiscal 2006. The lack of internal controls exposed by the outside audit could be an invitation to the corrupt, Gray said.

"That's the biggest budget in town," Gray said. "We're really worried about it."

A recent review by the D.C. Inspector General found at least 16 citations of the department of health for poor fiscal management. It was the agency most singled out by auditors, the inspector general reported.

Got a tip on the Medicaid program? Call Bill Myers at 202-459-4956 or send him an e-mail, bmyers@dcexaminer.com.