LDH testimony at Appropriations 040919

Louisiana Department of Health Secretary Rebekah Gee, center, testifies Tuesday, April 9, 2019, about Medicaid expenses to the House Appropriations Committee.

Several Louisiana House Republicans took advantage Tuesday of a hearing on the Department of Health’s $15 billion budget to sharply question the agency’s leaders on issues like Medicaid fraud and eligibility problems in the wake of critical audits of the agency.

The hearing showcased what will likely be a recurring theme for the state's Republicans, who have in recent months taken aim at Medicaid fraud as they prepare for re-election this fall.

Lawmakers heard details of the health department’s $15 billion budget, the vast majority of which comes from the federal government. One of Gov. John Bel Edwards’ key policies was the expansion of Medicaid, which has extended the health insurance program to cover half a million people in Louisiana.

The health department’s budget is set to increase by about $1 billion, based on the proposal from Appropriations Chairman Cameron Henry, R-Metairie. That increase is nearly all from federal money related to Medicaid payments.

State Rep. Rick Edmonds, R-Baton Rouge, said the agency’s growing budget deserves scrutiny, especially in the wake of a recent audit that Republicans claim show millions of dollars have been spent on people who were improperly enrolled in Medicaid.

“If you’re going to ask for an additional $1 billion. … (We) gotta have some confidence,” Edmonds said. “And things that do not bring confidence is the level of fraud, waste and abuse.”

The agency also revealed 1,600 people were identified as making $100,000 while being covered by Medicaid, well in excess of the income threshold. The department is still reviewing some of those cases, while most are no longer enrolled.

Edwards said in a statement that data showed why the new eligibility system for Medicaid is important, and stressed that 74 percent of those people are not enrolled anymore.

Around 30,000 people were recently booted from the Medicaid rolls after failing to prove to the state they were eligible for Medicaid, though officials said some of those people may actually be eligible. 

Health Secretary Rebekah Gee touted Medicaid expansion as a literal life saver for people who now have coverage through the program. And she noted the agency has a new eligibility system, which was in the works before the recent audit about enrollment, that provides more detailed information about enrollees.

“There will always be mistakes made in any very, very large program but if you look at the national rates and where Louisiana stands. ... We do very well according to the national statistics,” Gee said.

The state spends less per capita on Medicaid enrollees than the national average, according to a budget presentation unveiled Tuesday.

“Let’s be clear, if there is a criminal conviction of fraud related to Medicaid, we will aggressively pursue getting back the money,” Edwards said in a statement. “We take fraud, waste and abuse very seriously, which is why my administration prioritized this new eligibility system early on. Only those who are eligible for Medicaid should receive benefits.”

Still, Republicans spent several hours poking around the agency’s programs, particularly Medicaid, and even brought staff from the Legislative Auditor’s Office to the podium to answer questions about their audit findings.

The health department said it would bring answers later to many of Edmonds’ queries about overpayments, kickbacks and other illicit activity surrounding Medicaid, setting up another contentious debate surrounding the agency later this month.

“We intend to bring this to the forefront,” Edmonds said. “If we’re not talking about Medicaid, we’re not talking about the right thing.”

The comments by Republicans echoed similar lines of attack made by GOP gubernatorial candidates at a recent forum, where they criticized the Edwards’ administration handling of Medicaid.

Pollster Bernie Pinsonat noted Republicans’ base of support in Louisiana is generally opposed to the Affordable Care Act and Medicaid expansion, which is why the Medicaid issue will likely continue to come up this election year.

“Republicans know when they go back home, attacking Medicaid expansion or attacking Obamacare, it makes sense,” Pinsonat said.

The budget proposal heard Tuesday does not include any additional revenue sought by Gov. John Bel Edwards and recommended by state economists from increased tax collections. House Speaker Taylor Barras has blocked updated forecasts that would give the state more money.

The Revenue Estimating Conference, which is tasked with determining how much money the state has to spend, will meet again Wednesday in an effort to recognize revenue.


Follow Sam Karlin on Twitter, @samkarlin.