There was a burst of reporting today that the Legislative Audit committee might release early an audit of the state’s Medicaid program, otherwise not due to be completed for months. The rumor was that it would give fuel to Republicans who oppose expanding Medicaid.
Good reason to be suspicious. Rep. Bryan King, a Republican co-chair of the committee, indicated he had some advance news of the audit. How’s that, one wonders? Republicans have made a point of packing Audit, because they have already used it, and plan to continue to use it, to highlight the things they think wrong about state government. Nothing wrong with a watchdog. But with a committed Republican, Frank Arey, as chief counsel, a sympathetic audit chief, Roger Norman, who’s vowed to work by Biblical principles but hasn’t been particularly transparent about his own pay and some earlier examples of partisan posturing (OK, Martha Shoffner gave them a lot of material to work with, but some shortcomings were also spotted in audit’s work on her case), the shape of things had already become apparent.
The audit, which covers 2009-12, wasn’t released today. The way it works, the state agency has already seen the audit and been given some chance to respond. I tried to get that document and the agency response in advance. DHS said they couldn’t provide it until it was released, but they did say this in response to my question:
The release of the audit special report is very premature and highly unusual, especially considering we have repeatedly expressed concerns about its accuracy, the accounting methods used and the impossibly short timeframe our agency has had to respond.
The flaws in the report were so alarming that DHS officials contacted a UALR statistician and asked that he review some of the methods used by the auditor. He found that flawed sampling procedures and unsupported conclusions caused potential program errors and a huge overstatement of questionable costs.
In addition, the audit process is typically months long and provides DHS ample opportunity to challenge findings and provide necessary documentation. That has not happened with this audit report.
For example, on Thursday our staff received 25,000 documents on which some of the report findings are based. We were only given until tomorrow at noon to go through all of those documents, review the corresponding audit material and draft a response that reflects a more accurate picture of the Medicaid program.
DHS understands that in a program the size of Medicaid auditors will find areas in which we need to improve our processes or make changes to the program. It’s common for us to challenge findings in the yearly audits. However, in all of the years that DHS has worked with Legislative Audit, we have never seen a report like this in tone. It uses sensational but rare examples and questionable methodologies to paint the program in the worst light.
Would the Republicans cook up something to hamper Medicaid expansion?