One audit complete, another in the works
Gov. Bob McDonnell pledged during his 2009 campaign to scrutinize the state agency that oversees the state's Medicaid system.
"As governor, Bob McDonnell will require an independent performance audit of the Department of Medical Assistance Services seeking cost savings while streamlining bureaucratic red tape and eliminating waste,” McDonnell's campaign said in a Sept. 10, 2009 news release.
Jeff Caldwell, a spokesman for the governor's office, said this promise was fulfilled by a Feb. 2012 audit conducted by CGI Technologies and Solutions and KPMG.
McDonnell explained in an Aug. 27, 2012 memo to state legislators that the CGI audit looked at the findings of every audit of DMAS over the last five years and what steps the agency took to correct those problems.
The 47-page CGI report found that DMAS strives to do a good job addressing audit issues.
CGI also noted that there's room for improvement. For example, that DMAS hadn't fully implemented a previous audit recommendation to do background checks for all newly-hired employees. The agency also had not revised its processing system to automatically suspend certain Medicaid claims that might be covered by a third party, according to the audit.
CGI also said DMAS hadn't fully addressed previous findings that raised the possibility the agency made an overpayment to its transportation brokerage contractor and that the database the agency maintains to keep tabs on resolving audit findings often didn't provide enough details to determine whether issues had been properly resolved.
CGI reviewed DMAS cash balances and didn't find any "unusual fluctuations,” McDonnell said.
"This audit was intended to be a broad-ranging review of DMAS, covering all aspects of the agency's performance,” McDonnell said in his memo to legislators. "It is gratifying that the issues that the audit surfaced are neither numerous nor unmanageable.”
The governor also wrote that CGI is conducting an additional audit of the state"s Medicaid eligibility system.
An Oct. 11, 2011 draft report from the Joint Legislative Audit and Review Commission found that errors in Medicaid eligibility determinations at local social services departments may have resulted in the state making improper payments ranging from $18 million to $263 million in the 2009 fiscal year.
The new audit is looking for ways to reduce Medicaid eligibility error rates.
Under McDonnell, one audit of DMAS has been completed and another is in the works. So we rate this a Promise Kept.
McDonnell for Governor, "McDonnell, Bolling, Cuccinelli focus on health care,” Sept. 10, 2009.
E-mail from Jeff Caldwell, spokesman for Gov. Bob McDonnell, Jan. 31, 2013.
E-mail from Paul Logan, spokesman for Gov. Bob McDonnell, March 1, 2013.
Governor Bob McDonnell, memo to members of the General Assembly, Aug. 27, 2012.
CGI Technologies and Solutions, "Review of DMAS performance,” Feb. 2012.
Joint Legislative Audit and Review Commission, "Mitigating the risk of improper payments in the Virginia Medicaid program,” Oct. 11, 2011.