INDIANAPOLIS — The Family and Social Services Administration says more audits are on the way as the Braun Administration attempts to rein in Medicaid spending.
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“The free lunch is over,” FSSA Sec. Mitch Roob told WRTV in an interview.
Indiana’s Medicaid appropriations have spiked 134% over the last decade, according to the FSSA. It totaled $2.1 billion in 2017, compared to $4.96 billion approved for 2027.
“It’s easy to throw money at a problem,” Roob said. “We don’t have the money to throw anymore.”
That spike in spending saw annual Medicaid appropriations increases reach 9.5% on average. The Braun Administration’s goal is to cap growth at 2%.
State Rep. Gregory Porter, D-Indianapolis, has argued the 2% goal “will directly reduce or outright eliminate services for those who need them the most.” Roob tells WRTV the intent is to keep Medicaid spending limited to eligible recipients.
“Gov. Braun is determined to make sure that we’re providing an effective benefit but that we’re not allowing the taxpayers to be ripped off,” Roob said.
Balancing costs versus care came to a head with changes to the 340B drug program. It allows some health care providers to buy prescription drugs at a discounted rate, then charge insurance providers the full price. The profit is meant to help fund care for underserved populations.
The FSSA moved to change 340B so providers couldn’t charge Medicaid the full price while receiving a discount. It eventually added an exemption for Federally Qualified Health Clinics (FQHCs) after pushback from providers.
Christy Davis, the Director of Pharmacy Operations at Jane Pauley Community Health Center, said her clinic “literally cannot survive without the 340B dollars” in a phone interview with WRTV.
Some clinics relying on 340B act as the sole pharmacy option in their communities. Davis said, without the FQHC exemption, her clinic would have cut programs. Others may have closed altogether.
“This is the biggest relief that we have all had,” Davis said. “This was insanely stressful to us.”
The Damien Center previously told WRTV that 340B changes would cost it $5 million alone. Damien Center President & CEO Alan Witchey said the exemption “is helping preserve access to care for thousands of individuals across the state, particularly those in underserved areas” in a statement to WRTV.
Since Gov. Mike Braun, a Republican, took office, Indiana has added work requirements to the Healthy Indiana Plan (HIP), created new limits for a popular autism therapy known as Applied Behavior Analysis, and ordered some providers to stop advertising Medicaid programs.
More recently, the FSSA has begun audits.
FSSA announced it’s in a period of “expanded oversight” to “identify and address fraud, waste, and abuse across the Medicaid program”.
An audit of five attendant care service providers found nearly $200 million in improper payments. Roob said the state plans to look at every provider in that space.
The state also made sure it wasn’t funding fraudulent programs before Gov. Braun announced a $200 million investment to expand affordable child care across the state, Roob said. “We physically went to every single child care ministry and childcare center in Indiana to make sure that they had children there. And they did.”
Roob told WRTV that FSSA audits will focus on “high-risk” providers working in areas where the U.S. Centers for Medicare & Medicaid Services has identified fraud in other states. The FSSA is currently adding 400 new employees to help manage increased eligibility checks for HIP starting next year.
Despite the scrutiny, Roob claims the Braun Administration is not trying to make it harder to access Medicaid. “We’ve not closed one office. We’ve not changed eligibility criteria at all.”
