First it was $635 million in excess costs, now it’s $300 million in excess receipts.

It took months for North Carolina’s Department of Health and Human Services (DHHS) personnel to realize what a fiscal vortex the legislature created with mental health community support services, which eventually wasted $635 million. This weekend the Raleigh News & Observer reported that the state owes $300 million to the federal Medicaid program because of a mistake in how hospitals get paid. I suggested yesterday the $300 million mistake was convenient for cash flow regardless how inadvertent; it was both, but even more it was another reminder that bureaucracy (in government and in private organizations) is the handmaiden of waste, fraud, and abuse.