Medicare anti-fraud program helps vets and cash-strapped states

A 17-year-old computer data matching system designed to prevent welfare recipients from drawing benefits in more than one state at a time is now helping cash-strapped states save millions of dollars -- but not as originally intended.

Besides reducing fraud, the Public Assistance Reporting Information System allows state administrators to identify Medicaid beneficiaries who do not know they are eligible for military and veterans health benefits, thus allowing administrators to shift the financial burden of providing medical care for thousands of recipients entirely to the federal government.

PARIS, developed in 1993 by the Department of Health and Human Services' Administration for Children and Families, allows state public assistance agencies to share information about applicants and recipients of certain benefits. Until recently, participation in the program was voluntary, but in October 2009, in an effort to reduce Medicaid fraud, Congress required states to use the database as a condition for receiving Medicaid funding for automated data systems.

Bill Allman, a manager in the Washington State Department of Social and Health Services, said he hopes the mandate will push more states to actively pursue veterans benefits for Medicaid recipients who might be eligible.

Allman, a Vietnam War veteran, pioneered the use of PARIS for indentifying such beneficiaries in 2003 when he initiated a pilot program focused on long-term-care beneficiaries.

He was surprised to discover that many Medicaid recipients were eligible for veterans health benefits of which they were unaware, leading him to seek a systematic approach to identifying them. Care for those patients can then be shifted to the Veterans Administration, which provides equal and often greater benefits, at federal expense. What began as a three-year pilot has morphed into model program that other states are beginning to emulate.

Allman said the state has identified several thousand veterans eligible for VA benefits, as well as some eligible for TRICARE, the Defense Department's health program for retired service members and their dependents. The discoveries have led to better care for recipients and have saved the state millions of dollars, he said.

Other states, including California, Montana and Colorado have joined Washington in using PARIS to identify Medicaid recipients eligible for VA benefits.

Last week, Cindy Mann, deputy administrator at the Centers for Medicare and Medicaid Services, issued guidance to state Medicaid directors for complying with the new mandate.

"States may choose to match their [state public assistance agencies] data against other states' Medicaid, [Supplemental Nutrition Assistance Program and/or Temporary Assistance for Needy Families] program data through the PARIS interstate match. The interstate match can also provide states with information about applicants for and recipients of workers' compensation and child care benefits. States may also participate in more matches with federal agency data (e.g., data provided by the VA or DoD)," Mann wrote.

PARIS remains a voluntary program with respect to the Agriculture Department's SNAP program, formerly known as food stamps, and HHS' TANF program.