Blunt recommends job cuts at Medicaid review agency

JEFFERSON CITY, Mo. -- Although Gov. Matt Blunt has repeatedly said Missouri must do a substantially better job of rooting out waste, fraud and abuse in Medicaid, he has recommended cutting the budget for the agency responsible for carrying out that task.

Recommendations for budget cuts Blunt made to the House of Representatives last week included a $2.7 reduction -- and the elimination of 62 jobs -- at the income maintenance unit of the Division of Family Services. One of the key duties of the income maintenance staff is to review the eligibility of Medicaid recipients to ensure they qualify for taxpayer-funded health-care services.

Blunt spokesman Spence Jackson said the positions to be eliminated aren't directly involved in reviewing eligibility and that the governor wants to shift more of the 488 workers that would remain in the unit to that task.

"We'll be putting more emphasis on eligibility reviews than what was done before," Jackson said.

State Rep. Margaret Donnelly, D-St. Louis, said it is counterproductive for the governor to insist that the state improve efforts to weed out ineligible recipients while reducing the resources allocated to the agency that does the work.

In April 2004, State Auditor Claire McCaskill reported the state was doing a poor job of ensuring Medicaid benefits go only to those who qualify. As of June 20, 2003, McCaskill said 41 percent of Missouri's Medicaid recipients -- or 383,004 people -- hadn't had their eligibility reviewed within a year or longer.

In response to the audit, the Department of Social Services, which oversees Division of Family Services, said the staffing level of the income maintenance unit was at 46 percent of need based on the number of cases requiring review.

State Rep. Brad Lager, who chairs the House Budget Committee, said he was unfamiliar with the details of the governor's recommendation but that his committee believes more resources need to be redirected to fighting Medicaid waste.

"We are trying to work to move more people to checking eligibility," said Lager, R-Maryville.

Blunt has proposed $626 million in core cuts to Medicaid that would eliminate or reduce benefits for more than 100,000 low-income Missourians in order to bring state spending on the $5.3 billion program under control. Democrats have accused him of breaking a campaign promise to target waste and fraud in the program before moving to kick people off of it.

A House committee on Wednesday approved a bill that would make it tougher to qualify for Medicaid and allow for the budget savings the governor hopes to achieve. The committee made no changes to the measure as passed last month by the Senate, which is unusual for major legislation.

House Speaker Rod Jetton, R-Marble Hill, said he will try to keep changes from being made when the full chamber debates the bill next week so it can be more quickly sent to the governor and signed into law.

"I'm hoping we're able to keep it clean because I think it is a very good bill," Jetton said.

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