Medicaid Report: New Hampshire

Exploring Measures to Prevent and Detect Fraud
PRS Briefs
Tuesday, May 1, 2007

At present, more than 20 percent of total state spending nationally is dedicated to Medicaid, making it the second largest item in most state budgets after education. As funds become limited and health care needs expand, states must search for ways to cut costs while still providing quality services. With funding avenues exhausted, states seek to rein in costs by restructuring their Medicaid programs to produce greater efficiency, which includes initiating preventative measures against Medicaid fraud. Reducing the amount of Medicaid funds that go to fraudulent claims will increase the amount of money available in state budgets for health care funding and other needs. This report examines measures to prevent and detect Medicaid fraud, such as the implementation of more stringent enrollment controls and increased use of Information Technology (IT) for data analysis, and identifies sources for the expansion of fraud prevention programs in New Hampshire.