This morning the AJC ran a news article related to Senate Bill 63, which is proposed legislation with the stated aim to cut down on Medicaid fraud occuring here in Georgia. If you’ve been following Voices’ weekly updates, you’ve heard about this bill before as it’s one that we’ve been watching carefully. The bill calls for a mandatory pilot project that will utilize “smart cards” and may also include the use of other biometric identification measures (like electronic fingerprinting) to verify the identity of patients enrolled in Medicaid at every point of service, including doctors visits, when picking up medication at the pharmacy, etc. 

Voices has been concerned with how passage and implementation of this bill could have a negative impact. From the standpoint of the child enrolled in Medicaid, questions remain about how to verify the identity of a child or newborn through a photograph and/or through fingerprinting, if utilized. There’s also a conern as to how implementing these measures may further restrict Medicaid enrollees’ access to providers. Medicaid providers already are feeling strapped, since other legislative efforts this session include budget proposals to cut Medicaid provider reimbursement rates and to implement co-pays to be collected at the point of service by providers from children enrolled in PeachCare. If providers additionally are required to manage and maintain equipment and practices for more more stringent verification purposes of patients walking through their door, how many may decide that it’s not worth the hassle and forgo seeing Medicaid patients altogether?

Another concern is how this will impact the state’s bottom line. A fiscal note prepared in response to the original version of the bill gave an initial price tag of about $600,000 for a pilot program and over $23 million for a statewide rollout.

No system operates without fault and this is not to say that Medicaid fraud does not happen. There is a concern, however, that the measures proposed in Senate Bill 63 are not the best way to target fraudulent activity. And now with issues raised in the AJC article, questions are posed regarding how and why this proposed legislation came to be, providing even greater cause for concern.

Joann Yoon, Assoc. Policy Director for Child Health

Voices for Georgia’s Children