Medicaid Work in 11 States Sent Overseas; Privacy Worries Raised

Eleven states ship some of their Medicaid administrative work to foreign countries, including nine that have no specific protections in law to make sure private health information isn’t sent overseas, according to an inspector general’s audit released Monday that raises potentially thorny questions about the policy.

The Health and Human Services inspector general said it’s not illegal to use foreign contractors on some Medicaid work, and the inspector general didn’t report any evidence that privacy breaches have happened. The states all say they have written protections into their contracts to stop any personal health information from being shared.

But the inspector general said there is a danger of moving work to other countries that may not have the same privacy protections as the U.S.

Outsourcing work also runs counter to the Obama administration’s policy of opposing offshoring, something President Obama made clear in his 2012 presidential campaign when he repeatedly attacked Republican nominee Mitt Romney for being a “pioneer” of the practice.

Offshoring of medical work is controversial. Medicaid’s sister program, Medicare, requires written approval from the federal government prior to offshoring, but no such restriction applies to Medicaid.