In my home state of Michigan, Gov. Jennifer Granholm is using one of the Seven Harmful Habits of Highly Desperate States for Medicaid. According to the Detroit News
The state would place a 2.3 percent tax on physicians’ fees for services. The revenue would be used to leverage more federal aid for Medicaid,
and doctors whose patient caseload includes at least 3 percent Medicaid
recipients would get the tax payout returned to them. Those who rarely
treat any of the 1.4 million Medicaid recipients would not get a rebate.

The doctor will charge Medicaid the same $100 as
before, but the state will collect $2, reducing its contribution to $41
from $43 while the federal government continues to pay $57. This
gimmick will cut 4.5% from the $3.4 billion the state spends on

UPDATE: This should demonstrate why “Critics continue to claim that states are ‘gaming‘ the program in various ways.”