LANSING, Mich. — Sen. Roger Victory has requested the independent Office of the Auditor General to review Michigan Medicaid spending.

Medicaid spending has grown at an unsustainable rate and continues to have issues like fraudulent claims and improper payments, which ultimately hurt beneficiaries.

“Every dollar in Medicaid must benefit those whom the program is intended to serve,” said Victory, R-Hudsonville. “I look forward to hearing from the Office of the Auditor General as I work to ensure we are getting to the core of waste, fraud and abuse in this system.”

Victory asked for the following information:

• Systems and processes in place to ensure Medicaid beneficiaries are eligible and receiving appropriate services.
• Vulnerabilities that could lead to improper payments.
• Third-party service providers and their ability to demonstrate reimbursed services were provided to eligible recipients.
• Opportunities to streamline program administration.
• Total cost of coverage per beneficiary and what portion is administrative costs versus benefit costs.
• Processes in place to prevent, detect and address instances of waste, fraud and abuse.

“This review is a critical first step to help preserve the integrity of Medicaid and ensure the core services continue to be available for the people the program is intended to serve,” Victory said. “This issue affects every Michigan taxpayer, with Medicaid accounting for roughly one-third of all state spending. Moreover, it is particularly important for the more than 2.5 million who are entitled to benefits to ensure they have access to the essential, covered care that the program is designed to offer.”

The Michigan Office of the Auditor General conducts reviews as part of its mission to improve the accountability for public funds and to improve state government operations for the benefit of Michigan’s citizens. The OAG was established in Article IV, Section 53 of the Michigan Constitution.

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