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In response to the article on Medicaid in the June magazine, there is no question that these are challenging times, and states are struggling to meet ballooning health care costs. In my opinion, one of the main culprits for the trend here and nationwide is the fraud, waste and abuse associated with provider billing. My experiences in the early 1980s led me to the conclusion that there was something we, as legislators, weren't fully grasping: Why weren't we requiring explanation of benefits forms to be distributed to all Medicaid clients? Medicare already does this, so do most private health insurance providers. Why not Medicaid?

Providing these forms, with the added incentive of a 10 percent cash award, to those clients with adjudicated claims of provider overbilling would help plug the holes in the system. For the past two decades, I have consistently filed this legislation. Although estimates put the implementation cost at $1 million, the bill would save our commonwealth hundreds of millions of dollars.

A few years ago after following up on a constituent concern, I was able to uncover $3 million worth of fraud, waste and abuse of the Medicaid system in Massachusetts. Two different constituents of mine in past years have called me to report charges of overbilling by providers after reading the forms. The first complaint resulted in a $1 million fine of a Medicare provider. The second one resulted in a warning to a doctor.

The problem of Medicaid's skyrocketing costs appears to lie with the people who bill the state, not the clients. Are there other legislators out there who might have data and suggestions showing how explanation forms and a cash incentive to report fraud would affect Medicaid costs to states?

Marie J. Parente





I am pleased to announce that Maine has joined the list of states in your February magazine that have acted to promote organ donation.

Our new law provides the opportunity to use family medical leave benefits while donating a lifesaving organ, removing what the New England Organ Bank calls one of the most significant obstacles confronting a potential donor.

Legislation such as LD 1945 is simply an added tool that makes organ donation easier. Even the opponents said the impact on businesses would be minimal at worst. My only disappointment was that bone marrow donors were not included.

Statistics show that people sometimes die while waiting for donated organs. Nationally, there are more than 79,000 patients on waiting lists for lifesaving organs. And each year 6,000 of them die.

Despite the Maine Transplant Program's tremendous success, there are currently more people in the state awaiting transplants than there are available organs.

This law should help alleviate that dilemma.

Boyd Morley


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Publication:State Legislatures
Article Type:Brief Article
Geographic Code:1USA
Date:Jul 1, 2002
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