Federal officials are sending auditors to state capitals across the country to investigate techniques used by states to shift hundreds of millions of dollars in Medicaid costs to the federal government.
Also, under a proposed federal rule, the Bush administration will require states to prepare annual estimates of total improper payments and calculate payment error rates for Medicaid and the State Children's Health Insurance Program. States will have to identify the cause of each error, address it and recover any overpayments to health care providers.
The moves come as the administration is considering a wide range of other new initiatives to curb the growth of Medicaid spending, crack down on improper payments and help states save money by restricting eligibility and benefits.
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Under one proposal, states would be allowed to make many changes like increasing co-payments and limiting eligibility without having to get federal waivers. Local officials would also be allowed to provide different benefits in different parts of a state.
Such plans will stir impassioned debate in Congress. In a letter to President Bush last week, 47 Democratic senators expressed "opposition to any Medicaid reform proposal that seeks to impose a cap on federal Medicaid spending in any form or eliminates the fundamental guarantee to Medicaid coverage for our nation's must vulnerable citizens."
http://nytimes.com/2004/12/20/politics/20medicaid.html
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