Monday, February 28, 2011

Health, Human Services sees reduction in Fraud

The final phase of the budget is the time when constituent service is almost non-stop. We had 417 contacts this week, which is very near to an all time record. In the last five or six years, we have grown from around a hundred calls, emails, and letters a week to an average of between three and four hundred. While this is a fairly dramatic escalation in our workload, I didn’t get into politics because I thought it was effortless.

On the contrary, the reason I produce this column is to try and get you, the resident voter, to be more involved in the affairs of your district and your state. As your representative, I simply must hear from you regularly and in some detail if I am to place your ideas before the General Assembly. My colleagues at the statehouse, especially the ones I like and admire, are downright envious at the level of constituent involvement that 417 contacts represent.

Another reason I need to have extensive idea exchange with you is that a portion of what you read in the various media is incomplete or without proper context. It’s not that the newspapers, magazines and the radio producers are bad people or don’t do a good job-- often they are good people and they usually do a pretty fair job. It is because much of what we do is so detailed, so freighted with tradition or history, or (I’m embarrassed to admit) sometimes so seemingly irrational, that I can best explain it to you on the phone, or by email, or preferably when you come by the office and we chat about it. Consequently, the more I hear from you, the better job I can do.

Since much of what you wanted to hear about this week was concerning Health and Human Services, let me talk numbers. The Board of Economic Advisors (BEA) had a final budget forecast of $5,913,933,851, less the transfer of the tax relief fund of $545,000,000, leaving us $5,368,000,000, more or less. Out of that, the Capital Reserve Fund is $110,000,000 and the Contingency Reserve Fund is $71,000,000 with a BEA adjustment to around $68,000,000.

That makes the top line somewhere north of $5 billion. My subcommittee of Ways and Means is requesting Health and Human Services receive roughly $1.1 billion in state general appropriations, which is an increase of $435,000,000 over the current appropriation. The HHS top line number is reduced by annualizations and the $227,000,000 deficit from last year and around $4.5 million in IT expenditures required by the feds. We were then able to add nearly $90 million through a huge number of reforms in cash flow management, procurement savings, implementation of prior authorization for certain drugs, aggressive managed care capitations, as well as much more aggressive enforcement of fraud and abuse collections. Much of the credit for these innovations and administrative adjustments goes to Tony Keck, the new head of HHS about whom I wrote some time ago.

The fraud and abuse saving may be even higher if a measure put in by your representative becomes law. It mandates the prominent placement of a fraud hotline number where WIC vouchers and food stamps are used. If you see fraud or abuse, use the number. More times than not, the infraction is about evolving regulations, but oversight is certainly a deterrent to abuse.

Sorry about all the numbers. I look at them every day and they still make my head hurt.