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Exclusive–Rep. Buddy Carter on Welfare: We Can Weed Out Waste, Fraud, and Abuse Through Private Contractors

CHIP Childrens Medicaid
Spencer Platt/AFP/Getty

Rep. Buddy Carter (R-GA) argued in an exclusive interview with Breitbart News that his legislation would allow states to rein in waste, fraud, and abuse in Medicaid. He also called for states to have the same flexibility in other welfare and entitlement programs.

Rep. Carter sponsored H.R.1333, the Freedom to Use Contracted Entities Act – a bill that would allow private contractors to make eligibility determinations on behalf of State Medicaid programs – an idea that could have far-reaching implications for cutting waste, fraud, and abuse throughout federal and state bureaucracies.

According to a February 21 Health and Human Services  (HHS) Department report, California spent $738.2 million on 366,078 Medicaid expansion enrollees who were found to be ineligible; California also spent an additional $416.5 million on 79,055 enrollees who were found to be “potentially” ineligible.

Auditors for the HHS detailed in the report how roughly 90 percent of the $1.15 billion in potentially fraudulent Medicaid payments involved federal dollars.

Rep. Buddy Carter (R-GA) told Breitbart News in an exclusive interview on Wednesday how his legislation would curb waste, fraud, and abuse such as the fraud in California.

Carter explained the legislation to Breitbart News, “First of all, I think this is great legislation, it’s common sense legislation if you think about it, a contractor who could look at these applications and screen them would cut down on what is essentially waste, fraud, and abuse.”

Carter continued, saying, “In this case of California, when they did their expansion they could have saved $1.1 billion for people who were ineligible, and most of that money is federal dollars. Some of it is state Medicaid dollars, but most of it was federal dollars, and we understand that there are people who are eligible and who need these benefits, but what we’re aiming for is people who might have had incomplete or fraudulent applications.”

The Georgia Republican said, “If you look at what was done in Illinois, they were able to cut down, over a period of time, over 700,000 applications because they were fraudulent. Also, they had over $12 million from people who were deceased and still receiving benefits. That’s where an outside agency, or an outside party, would be able to assist state governments in making sure that these applications were correct.”

In an exclusive interview with Breitbart News, Kentucky Gov. Matt Bevin’s deputy chief of staff, Adam Meier, called for states such as Kentucky to use private contractors’ better service for state welfare and entitlement programs such as unemployment insurance and Supplemental Nutrition for Assistance Program (SNAP), or food stamps. 

Congressman Carter supported Meier’s call for greater state flexibility to use private contractors to service welfare programs, although he added that his legislation would grant states blanket authority to use private contractors, compared to current law that requires federal waivers.

I don’t think there’s any question about it and I think the Kentucky model should be followed,” Rep. Carter argued. “There’s no question we want to make sure that these people get these benefits, but we know that there is so much waste, fraud, and abuse that we can weed out a lot of it through private contractors. We’ll make sure that the people that truly need it get it in a timely fashion and will save the taxpayers money by making sure we cut out waste, fraud, and abuse.”

Carter continued, “I think giving the states the flexibility to contract with outside groups who can do a better job than the state agencies can, quite honestly. Let’s face it, state agencies are spread thin as it is and obviously they are not doing as good of a job as they can be. This is just an example of how we can give states more flexibility to do a better job. I think it’s going to make the programs better for those who truly need the programs.”

“Our constituents want us to cut out waste, fraud, and abuse,” Carter charged.

Those are the kind of things that really upset them,” he added, referring to California’s and Illinois’ history of Medicaid abuse. “We’ve got to reform some of these programs.”

When Illinois hired private contractors to find waste, fraud, and abuse in its state Medicaid program, they disenrolled roughly 700,000 fraudulent Medicaid recipients. Based upon projections from Illinois policy, taxpayers could save between $390 t0 $430 million per year, with even greater savings over time. 

Carter also argued that his legislation would mesh very well with President Donald Trump’s campaign promise to “get our people off of welfare and back to work.”

The Georgia Republican explained, “I think this works very well. The fewer people who are able to game the system, the more people we can get Americans working. This is what the Speaker [Paul Ryan] has talked about with workforce development. Right now we need more workers and we want to give them the opportunity to share in the American dream and to have a job, and that’s why we need to have a reform of these programs.”

Rep. Carter then suggested that House Republican leadership has been “very receptive to this and very interested in it. I think we will get their support.”

Carter then suggested that much of conservatives’ support for Obamacare repeal bills such as the House-passed American Health Care Act (AHCA) and the Graham-Cassidy block grant proposal has been focused on giving states flexibility to manage their programs at a local level.

“When we did the American Health Care Act and we passed it, Medicaid reform was part of it,” Carter contended. “We heard from the states at that time, they said, ‘We need flexibility within the program.’ This gives them that flexibility.”

Carter concluded, “I like Graham-Cassidy and I think that is the way that we can get these programs under control. The states can do a much more effective job of managing their programs compared to our federal cookie-cutter mentality.”

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