Missouri Republicans obviously relished eliminating thousands of needy residents off the Medicaid lists, but a report released today by Auditor Claire McCaskill indicates the state could have saved millions just by managing programs professionally.
The headline on the audit's cover sheet said, "State could save millions in Medicaid costs by better managing medical equipment and non-emergency medical transportation programs."
The audit also contained the following findings:
-"Missouri could save $5.4 million annually with competitive bids. As of May 2005, state officials had not initiated such bidding."
-Auditors found Missouri paid more than eight contiguous states on 41 percent of the 1,139 medical equipment devices reviewed. For example, Missouri paid $2,240 for one prosthetic device, while four other states paid only $1,830 for the same device, a 25 percent difference."
-"Despite a state law requiring purchase preference for Missouri products, auditors found $4.8 million paid to non-Missouri medical equipment providers." Missouri providers offered the same items.
-The state paid the Medicaid transportation contractor $44.1 million over 15 months, with the company making at least $19 million in gross profit. The contractor also picked up an 87 percent gross profit margin on the mileage reimbursement program.
-The contractor arranged medical transportation through taxis or through personal vehicles when public transportation would have been cheaper. "In one example," the audit report said that in one example "A recipient wanted to drive himself. The contractor reimbursed (him) 15 cents a mile or $3.60 for the trip, then the state paid the contractor $98.44 for administrative services for that trip.
Department of Social Services Director Gary Sherman indicated he agreed with most of the auditor's recommendations, with the exception of one. The audit recommended competitive bids be taken for medical services. Sherman said that would be done if an analysis showed it to be cost-effective.