On September 30, 2009 Ann Clemency Kohler, the Director of the National Association of State Medicaid Directors (NAMD), appeared before the SenateHomeland Security and Governmental Affairs Committee, Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security to speak about reducing fraud, waste and abuse of controlled substances in Medicaid.

From the Briefing:

It is also important to remember that abuse of controlled substances is not solely a Medicaid issue. According to a 2007 report by the Coalition Against Insurance Fraud, abuse and fraud related to drug-diversion scams costs private insurers nearly $25 billion annually. This represents over 1/3 of all costs related to drug-diversion scams. The Medicare prescription drug benefit is not immune to provider and beneficiary fraud either, as several GAO recent reports suggest. Fraud, waste and abuse are significant issues that all insurance providers must address. Medicaid agencies, like other health insurers, are attempting to mitigate these issues through a variety of activities intended to identify and prevent fraudulent activities and to strengthen existing protections. Additionally, fraudulent behavior occurs in very small segments of the population. It is easy to become reactive to high-profile, worst-case examples, but Medicaid agencies must balance activities to identify fraudulent behavior with the need to ensure that the vast majority of honest providers and beneficiaries receive necessary services.

Full briefing: Reducing Fraud, Waste and Abuse of Controlled Substances in Medicaid (PDF | 192.5 KB)