Well, a key piece of the stopgap spending bill House Republicans want to see approved this week targets big funding cuts for Medicaid.

Now, GOP members, both in Congress and New Jersey's legislature say it's a valid way to root out waste, fraud and abuse within government.

In fact, state watchdogs here have identified more than $1 billion in fraud within the program over the last decade and clawed it back.

But with close to 2 million New Jerseyans and 72 million Americans who rely on the health insurance program, experts say fraud is not the biggest expense with Medicaid, and there's likely not much more to find.

Our senior writer, Colleen O'Dea, dug into the issue and is with me now in the studio.

Colleen, you spoke with the state comptroller who goes after these scammers and bad actors.

What did he tell you about why he believes there's just not that much more out there?

You know, so they they have a certain amount of staff, and there's only so much work that they can they can do and, you know, they are on it.

24 well, not 24 seven but, you know, they're on it.

They're on it all day.

Every their main priority, right.

I mean, he said that they find fraud or overpayments every single day.

Not everything is is fraud.

There can sometimes be overpayments that happen innocently because people are unaware of all of the regulations.

There are a lot of rules in order to try to make sure that there's not money being misspent by Medicare, Medicaid and Medicare.

So people may not have filled out the right forms or they may not have, you know, dotted all the I's and crossed all the T's.

So the comptroller's office does education to try to, you know, help that right to, to prevent that.

Right.

I mean, compliance is one part of it.

So he acknowledges, obviously there are issues, as they are with any program.

Yet how do you keep it in place and ensure that the people who need it are getting that help while also taking out the bad actors?

I mean, is there a way to do that that doesn't, have to be slashing the program entirely?

Just the idea that that all of these offices, not only in new Jersey, but across the nation, are charged with this making sure that they have the staff that they need to continue to go after, these overpayments, this, this fraud and, you know, not, getting rid of the inspector general at the Department of Health and Human Services, who's who oversaw all of this effort.

I mean, that's one of the cuts that was made very early on in this administration.

That inspector general and others are suing.

I mean, their job is to find this kind of fraud.

So it's kind of like you don't say, well, there's some fraud.

So we want to get rid of the program, you know, throw the baby out with the bathwater, as they say, right?

You make sure that the money gets to the people who need it.

As you noted.

I mean, there are almost 2 million people in new Jersey who rely on this children.

880,000.

I think it's just the need is huge.

And you don't get rid of that program because what do you replace it with?

So you mentioned fraud is one area overpayments are another.

Where else did you find, that there is waste.

Is it a lot of it within just the regulatory process of applying through Medicaid, getting the the payments and applying them correctly, is that where some of the waste comes in?

Yeah.

I mean, you know, unfortunately, as the comptroller said, he sees a lot of issues in nursing homes, that there have been several, high, really high profile cases in new Jersey.

In one case, it was $35 million that they say where nursing home owners have kind of funneled payments, money that they've gotten from Medicaid into other companies that they own, while neglecting the care of the patients.

So you've got two problems there.

You've got the money being taken from Medicaid improperly, and you also have people just not getting the care that that they should.

So certainly, tougher enforcement of Medicaid rules and looking harder at them.

Labs is another big place that they've seen problems where a lab will, you know, bill a few bucks to a private insurance, but then bill Medicaid, more than $100 for the same test.

That's the kind of stuff that you need people to be, you know, combing databases and looking at.

And that's where you find it.

But you need the people to be doing that, or else it's not going to it's not going to get found.

And very quickly, what's at risk for new Jersey if these cuts were to go through?

I mean, if if the cuts are to go through, according to the Department of, of Human Services, depending on what cut it would be, you're looking at, tens of thousands, hundreds of thousands of people losing their coverage or the state having to pony up, you know, millions and millions of dollars to cover that.

And again, these are these are disabled people, elderly people, children.

And you know, families that just can't make ends meet.

All right.

You can find Colleen Oda's full report on our website, NJ Spotlight news.org.

You can find all the rest of her reporting there as well.

Colleen, thanks for coming in.

Thank you very much, Bri.