Two top advocacy groups are accusing Mississippi State Auditor Shad White of misleading Mississippians with a report claiming that up to 5% of Mississippians receiving Medicaid do so fraudulently. White announced in a statement on Tuesday that his office had discovered that the Mississippi Division of Medicaid was “potentially handing out millions to ineligible people.”
“We now have enough data to show there are millions of dollars of potential savings if we can prevent ineligible people from getting on Medicaid. The benefits should only be going to those who deserve to be on the program,” White, a Republican, said in a statement on Tuesday.
American Civil Liberties Union of Mississippi Executive Director Jarvis Dortch told the Mississippi Free Press on Wednesday that White’s public announcement, which sampled 180 Medicaid beneficiaries for its findings, failed to emphasize key details included in the audit. The omissions included that the auditor could not verify that the 14 “potential” cases of fraud cited were, in fact, fraud.
“The audit itself says that they are speculating that 180 may not be eligible. … Even in the audit, it points out that they’re looking at data from 2018 because of the pandemic, at the earliest 2019,” Dortch said.
“… Somebody’s circumstances could be very different especially during a pandemic than they were a year before. So just because two years earlier you didn’t qualify for Medicaid or your child likely didn’t qualify for Medicaid, that doesn’t mean you don’t qualify at this moment.”
‘There Was Suspicion Of Fraud Outside This Audit’
In the statement, the Republican auditor also alleged that among Mississippi’s Medicaid recipients “are two individuals who own multi-million dollar homes and declared high incomes on their most recent tax returns, but also receive Medicaid benefits.” The audit notes that the Mississippi Division of Medicaid “informed” auditors of those instances as “possible fraud cases” that the agency was already investigating.
Logan Reeves, who handles media relations at the Office of the State Auditor, told the Mississippi Free Press today that those individuals are “separate from the sample” of 180 recipients used in the audit.
“Those two I believe were reported to us by Medicaid. I think they had already suspected some type of fraud there and had not taken any action. … So there was suspicion of fraud outside of this audit,” Reeves said.
Among those identified as potentially ineligible within the sample, the auditor’s report notes that the “auditor could not determine with certainty that individuals are, in fact, ineligible,” citing insufficient information collected by the Division of Medicaid. Reeves told the Mississippi Free Press that it is important to understand the difference between an audit and an investigation.
“The audit is testing internal controls determining whether the internal controls in Medicaid are sufficient to be able to maintain a program’s integrity. … When you move into the investigation really is when you have identified folks who potentially have committed some kind of fraudulent act and have put one thing on their application and have another thing on their tax return. I don’t know how you get anywhere else but fraud,” Reeves said.
“The investigative part is where you confirm, ok, we’ve moved past this idea of maybe this person slipped through the cracks and we’re on a, this person did not slip through the cracks, they lied on the application or they lied otherwise. There’s a criminal act that allowed them to be on this program.”
‘We Have The Stingiest Medicaid Program In The Country’
Dortch said he worries that White, who is politically conservative, is using those two instances and incomplete information about other recipients to justify a push for further restrictions on Medicaid recipients.
“He was very targeted with what he was trying to do, which was to get headlines in the news that millionaires were getting Medicaid and that we’re wasting millions of dollars on Medicaid when we have the stingiest Medicaid program in the country,” Dortch said. “We have people going without because we put these incredibly stupid barriers in place because we have politicians who just want to keep banging the drum about fraud instead of wanting to make sure people get the assistance they need.”
Dortch and other critics of White note that, despite the fact that the state audit spans 338 pages and includes only a small section devoted to Medicaid, White focused his public remarks and statement on allegations of “Medicaid fraud.”
Southern Poverty Law Center Action Fund Policy Director Brandon Jones called White’s announcement “misleading and sensationalist.”
“The audit acknowledges several times that it cannot determine whether the individuals it singles out were, in fact, ineligible. Nevertheless, knowing that the audit cannot make that determination, Shad White still treats them as ineligible and calculates a worst-case scenario analysis that is meant to get the public hyperventilating about a problem that doesn’t exist while using a worn-out tradition of dog whistling on welfare fraud,” Jones said.
“Medicaid eligibility is determined on a yearly basis, although people are required to report changes in income,” he continued. “That means some people who were eligible the year before became ineligible the next year based on their income. But since eligibility is determined on a yearly basis, it can take time for people to lose their eligibility. This is not ‘fraud,’ it’s the way the system works.”
Reeves told the Mississippi Free Press that those accusing White of political motivations are “certainly entitled to that opinion, but the truth is, this audit is required by the federal government to accept federal dollars.”
“So another way of saying that is, if we did not conduct this audit, we’d blow up the federal matching portion of the Medicaid budget. And that just, that wouldn’t work,” he said, pointing to the federal policy on Medicaid audits.
White: ‘I’m Your Huckleberry’
Several news organizations in the state reported White’s claims of fraud before Medicaid advocates were able to contest the remarks. Dortch said he understands that journalists may see the auditor as holding a more apolitical position, but urged reporters to spend time “reading the actual reports before taking somebody’s press release” and reporting it.
“I don’t want to play media critic; I just think that this issue, it’s reading the actual reports before taking somebody’s press release. I think that should be demanded or just be curious as a reporter, just don’t take anything at face value,” he said.
In a statement Wednesday, though, White defended himself and said Dortch, a former Democratic member of the Mississippi House, owes him an apology.
“Two years ago, the now-head of the ACLU asked to come to my office to discuss Medicaid. I agreed,” he said. “I asked him if it was possible for a Medicaid applicant to lie about their income to get Medicaid. ‘That’s not happening,’ he said. My audit this week proves him wrong. We know there are people living in million-dollar homes getting Medicaid. I’m still waiting on my apology letter from the ACLU.
“They accuse me of singling out Medicaid for auditing as a part of a political agenda. They probably didn’t know that I’m required by the federal government to audit Medicaid every year. But, by all means, never let the facts get in the way of a good story you can tell your donors, ACLU and MCJ. You’ve got to pay your salaries somehow.”
White accused the ACLU and SPLC of painting him “as some sort of cartoonish, poor-hating thug.”
“To these groups, if you thought you found someone who will roll over to your nonsense, I’m not the one. I’m your huckleberry,” the auditor wrote.
Medicaid advocates express more substantive concerns, however. They worry that White’s statements could harm efforts to expand Medicaid in the state, which some estimates show could bring health-care options to between 200,000 and 300,000 Mississippians. In the SPLC statement, Jones said Mississippi needs to “strengthen and expand Medicaid, not attack it to score cheap political points.”
“It is frankly exhausting that public officials in one of the poorest states in the country repeatedly feel the need to attack people on public assistance,” Jones said. “The income of people fluctuates, and it’s not surprising that in the middle of a pandemic some people who were doing well before have now hit hard times. Medicaid and other public-assistance programs have been literal lifesavers for many people in Mississippi.”