"We do post-payment review," she said. "We pay it and, if we think it's inappropriate, we go after it."
In a related issue Wednesday, House Finance Chairman Brent Boggs, D-Braxton, continued to raise concerns about a large backlog of individuals on the wait-list to qualify for Medicaid Aged and Disabled Waivers, which provides in-home care services.
As of July 31, there were 2,347 West Virginians waiting for the 6,275 slots available, according to BMS reports.
In 2012-13, 246 people were removed from the wait-list because they had died. Comparatively, only 204 people moved off the wait-list into the waiver program that year.
"So they passed away without receiving any services while on the wait list," Boggs said of the 246.
Tina Bailes, Department of Health and Human Resources deputy commissioner for finance, told the Joint Committee on Government and Finance it would take an additional $12 million of state funding to clear the wait list.
Senate President Jeff Kessler, D-Marshall, said a key problem is that, under federal regulations, once a slot becomes vacant, it cannot be filled again until the next fiscal year. If a participant dies or is transferred to a nursing home on July 2, that slot remains vacant for 364 days, he said.
"It seems like a lot of people could be helped now, instead of a year from now, when they may be dead," he said.
Boggs said correcting problems with the waiver program is a cost-effectiveness issue, since people denied in-home care frequently end up in nursing homes at a much higher cost to the state.
"I don't know why we're not taking advantage of a program that has a 3-to-1 federal match," Boggs said of the waiver program.
Reach Phil Kabler at p...@wvgazette.com or 304-348-1220.