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N.C.’s big Medicaid bill

From an editorial Monday in the Fayetteville Observer:

“A billion here, a billion there – pretty soon you’re talking about real money.” The quote was long attributed to the late Illinois Sen. Everett Dirksen. He never really said it but liked the sound of it so much that he adopted it anyway.

Somebody in Raleigh could claim the quote soon. It’s getting close to describing the latest episode in Medicaid overspending. It’s a little short of a billion – about $835 million, according to state auditors – but in a state program, that qualifies as real money.

The amount of overspending is a projection from State Auditor Beth Wood’s staff, based on a small sampling of payments made to doctors and hospitals by the joint federal-state health-insurance program for the poor and disabled. She calculates the state’s share of payments at about 35 percent.

The audit attributed overpayments to insufficient proof that services occurred, ineligible medical providers seeking payment and mistakes in payment rates.

State Medicaid administrators say the errors don’t necessarily mean fraud.

Still, it is fair to say the state still has work to do. Medicaid error rates are too high and money is being wasted – money that would be better spent on an expanded Medicaid system that could plug the holes in health-insurance coverage for this state’s lower-income workers.

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