Medicaid Expected to Improve in the City; New Agency Created to Relieve Problems

Article excerpt

Byline: Gary Emerling, THE WASHINGTON TIMES

D.C. Council Chairman Vincent C. Gray said moving the administration of the city's long-troubled Medicaid program to a new Cabinet-level agency will hasten reform in the long-troubled department.

"Moving towards creating a separate department would have to be influential to those who are concerned to say that the District is taking steps with this function to try to give it the autonomy and strengthened management that it needs to effectively do its job," Mr. Gray told The Washington Times.

The Medical Assistance Administration, which currently administers the Medicaid program, has been criticized for mismanagement and overpaying providers. A D.C. Inspector General last year said the city overpaid some health plans by roughly $97 million.

The council last month passed legislation moving the department's authority to a Cabinet-level agency called the Department of Health Care Finance.

The department had been a division of the Department of Health, whose director, Gregg A. Pane, was fired by Mayor Adrian M. Fenty in October.

The new agency will assume administration of Medicaid and the city's HealthCare Alliance. It will work to "ensure effective and efficient use of Medicaid dollars," according to the legislation, which was signed by Mr. Fenty on Dec. 27.

Mr. Gray said he would like to see an in-depth management review of the Medicaid program. The review would likely come after the mayor submits a transition plan for the new department, which is due by March 1.

"It's really an opportunity to do the kind of management review .. where we look at the existing policies and procedures and whether they're being

effectively implemented," said Mr Gray, a Democrat.

Mr. Gray said the review could extend to a forensic audit, an in-depth examination of financial records and transactions often used to look for the existence of fraud or abuse.

"It isn't as if there's some smoke and we're looking for the fire," Mr. …