To understand waste, fraud and abuse of taxpayer dollars in the Medicaid system, let’s begin with a couple of basics on what the role of Medicaid is in health care and how it works.
Medicaid Basics
Medicaid is a program for people who cannot afford health care that is dually funded by both the federal government and states. (Medicaid is different than Medicare, which has no state dollars and is fully funded by the federal government for those over the age of 65.) In Texas, we spend about $30 billion dollars a year on Medicaid – almost a quarter of the entire state budget. Over 3.7 million Texans are enrolled in Medicaid in Texas and one-third of them are children. Patients enroll in Medicaid through HMOs.
via Texas CEO Magazine – Medicaid Waste, Fraud and Abuse in the World of Managed Care.