House Splits on Measure to Require Health Care Authority To Verify Eligibility and Identity of Every Medicaid Applicant

OKLAHOMA CITY (22 March 2017) – Legislation that would require the Oklahoma Health Care Authority to verify the eligibility of every person who applies for Medicaid health-care benefits, and require every applicant to complete an identity authentication process, cleared the House of Representatives Wednesday night.

House Bill 1270 by Rep. Elise Hall, R-Oklahoma City, passed on a 63-25 vote. Every vote in support of the measure was cast by a Republican. Four Republicans joined 21 Democrats in opposition to the bill.

HB 1270 would direct the Oklahoma Health Care Authority (OHCA) to verify the eligibility of every applicant for Medicaid. An amendment proposed by Rep. Collin Walke, D-Oklahoma City, deleted any reference to SNAP (the food-stamp program) and Temporary Assistance to Needy Families (TANF), leaving the bill focused exclusively on Medicaid.

Hall said her intent is to ensure that “people who truly need public assistance get it.” The State of Oklahoma has “limited resources,” she said during a House committee meeting earlier this month.

The federal government estimates that nationwide, 10% of all Medicaid payments are fraudulent, Hall said.

Rep. David Perryman said records indicate most of the fraud in Medicaid occurs among medical providers, not patients. The cheating in Medicaid occurs primarily among providers who submit fraudulent invoices to the government, the Chickasha Democrat maintained.

Allegations of fraud among Medicaid providers is the province of the Attorney General’s office, said Hall. She said the state is being defrauded via “eligibility errors.” Her focus, she said, is fraud committed by individuals “receiving the benefits.” She wants their “liquid assets – bank accounts and cash” – to be monitored annually, at a minimum, but preferably quarterly.

An estimate of the potential cost of auditing all Medicaid beneficiaries once a year or every three months was unavailable Wednesday night.

According to the Oklahoma Health Care Authority, almost 826,000 Oklahomans (two-thirds of them children and one-third of them adults) were enrolled in SoonerCare (this state’s Medicaid program) in February.

Considering the size of Medicaid, “Of course there’s some fraud,” said Rep. Forrest Bennett, D-Oklahoma City. “But don’t cancel the whole program. There’s fraud in corporate welfare, but we don’t cut their programs.”

Oklahoma has “a low error rate” in its SoonerCare program, said Rep. Regina Goodwin, D-Tulsa.

In fact, the OHCA’s audited error rate – in its eligibility approvals as well as its claims payments – is less than one-half of 1%, ledgers reflect.

Oklahoma’s Medicaid program is funded with approximately $5 billion; of that amount, about $1.7 billion is state tax dollars and the remainder is federal aid. The OHCA’s share of that figure is $1 billion, and the $700 million balance is allocated to the Department of Human Services, etc.

Hall contended her legislation could save Oklahoma as much as $80 million per year.

House Minority Leader Scott Inman, D-Del City, was skeptical of that estimate, asserting that it simply came from “out of the sky.”

The average Medicaid benefit for a recipient in Oklahoma is $6,370 per year, Inman said. To achieve a tax savings of up to $80 million from Medicaid audits would require nothing short of “a financial windfall,” he said. “Over 50,000 poor people would have to somehow luck into winning the lottery, or their Aunt Irene died and left them a fortune.”

“Has there been evidence of inappropriate receipt of benefits?” Rep. Meloyde Blancett, D-Tulsa, asked Hall during the House Rules Committee meeting March 1.

Not in Oklahoma, but in other states, Hall said. News stories indicate several lottery winners in Maine, Massachusetts, Michigan and New York improperly received public welfare benefits.

For example, a New York resident who began receiving $1,000 each week in 1998 after winning a scratch-off lottery game was charged with fraud in 2012 after collecting more than $4,000 in welfare benefits. And a Michigan woman received $5,475 in food and medical benefits after winning $1 million in the lottery.

HB 1270 would instruct the OHCA to review information about program recipients that might affect their continued eligibility for public benefits. “Often times the state is checking these only once a year,” Hall claimed.

However, the Oklahoma Lottery Commission says it routinely checks the names of lottery winners against DHS child support enforcement records; against Oklahoma Tax Commission rolls, to determine whether a winner has any tax payments in arrears; and with the Oklahoma Employment Security Commission, to determine whether a lottery winner is collecting unemployment benefits.

Hall said she just wants to “make sure there’s no fraud and abuse in our benefit programs.” Her legislation would demonstrate that “we’re wisely using tax dollars,” she said.

She said her measure is modeled on legislation from other states. Perryman said HB 1270 is “cookie-cutter legislation” patterned after a proposal developed by the Foundation for Government Accountability, where former state Rep. Tom Newell, R-Seminole, is now a senior fellow.

During the committee meeting, Perryman described HB 1270 as “a solution looking for a problem.”



Media Director, Democratic Caucus
Oklahoma House of Representatives
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