Audit of Wis. Medicaid program raises concerns

Smith said separately tracking budget activity for all the individual programs would be time consuming and difficult and limit the department's flexibility to manage fluctuations.

Smith said DHS has implemented a new process to review all contract changes to make sure enough money is available and proper rules are being followed. Smith said all existing Medicaid contracts are being reviewed to assess their value and relevance.

The department is also working with counties to put in place a new program for determining eligibility for Medicaid and FoodShare programs, Smith said.

The audit also said DHS did not ensure that adequate funding was available before authorizing additional contract work or make sure that services were obtained at a competitive price.

Payments to vendors who provide administrative support to the Medicaid program grew by 73 percent from about $66 million in 2006 to nearly $115 million in 2010.

The audit says that the department's increasing reliance on vendors may hamper its ability to provide guidance to those contracted staff and to maintain adequate oversight.

Smith said the department is also exploring opportunities to use state employees instead of outside contractors where appropriate.