Medicaid beneficiaries with health conditions aren't always receiving the preventive services they need, the Government Accountability Office reported.
In analyzing national survey data and interviewing state Medicaid directors and federal officials, the GAO found that more than half of all Medicaid adults ages 21 to 64 were obese or had diabetes, high cholesterol, high blood pressure or a combination of these conditions, yet the receipt of some preventive services was low.
The data also suggested that a lower percentage of Medicaid adults received preventive services than those with private insurance, and that many Medicaid children were not receiving well-child checkups. Most states reported that they covered most but not all of eight recommended preventive services reviewed by the watchdog agency. Nearly all state Medicaid programs said they covered cervical cancer screening and mammography, but less than a third covered intensive counseling for obesity or high cholesterol.
The GAO said the CMS should ensure that states' early and periodic screening, diagnostic and treatment programs be reviewed on a regular basis. The GAO also said the CMS should step up its efforts to provide guidance to states on coverage of obesity-related services. The CMS agreed with the suggestions.
