Thirty years ago many believed that with the increasing sophistiaction of computers, there would be far more leisure time for us all and a decrease in paperwork, as we moved to more paperless ways of keeping records. However, the Department of Redundancy Department, which has Medicaid as a charter member, decreed that we must deforest the land by killing ever more trees to produce a blizzard of nonsense paperwork.
Yes, there is the call for Medicaid to reduce Medicaid fraud by service providers. Other than reviewing the billing to see that what was submitted is consistent with the size of the provider and their past history, one logical way to do this would be to make spot onsite audits of these providers to observe that these providers are actually providing the services billed for and to see that the quantity and quality of services provided by the observed staff is consistent with what Medicaid was billed for. But, who said that Medicaid or government in general was ruled by logic?
Instead of doing actual site visits to see that the staff of the provider agencies are actually providing the services that are billed for and reviewing whether the numbers submitted are consistent with the size of the provider, Medicaid has required an increasing number of meaningless forms, which makes it harder to notice numerical discrepancies or have time for surprise onsite visits. One example is the intervention sheets with the check boxes used in programs for people with developmental disabilities. Residential Habilitation (rehabilitation was turned into habilitation by some genius who said that you can't rehabilitate someone who wasn't habilitated in the first place) Day Habilitation and Pre Vocational Services are examples of programs with these sheets with the check boxes..
I submit that the concern for Medicaid should be whether the person receiving services is actually there and whether the services claimed are actually provided. Just because a box is checked on one of these sheets signifies nothing other than that someone checked and initialed the box. But, it takes staff time to create these sheets, more time to check the boxes and sign off on the bottom of these records, and still more time for an administrative assistant to verify that all the boxes were checked when the program participants were present, but none checked when they weren't present and that each staff initialing a box signed the sheet on the bottom to identify who provided the service. Then this administrative assistant has to fax these sheets at the end of the billing period (usually a month) to Medicaid, sometimes through a central office, which again checks these sheets for accuracy killing yet more trees at every step in this process.
Think of how many man hours are wasted in this meaningless documentation that could be better used to provide services to the program participants. And, this is but one example of how forests are being killed for a blizzard of meaningless Medicaid paperwork that signifies nothing.