A report released late last month by state Auditor General Jack Wag-ner did not get the attention it deserves, considering it identifies hundreds of millions of dollars — or more — of potential savings for state taxpayers.

Wagner's auditors examined 1,900 randomly selected Medicaid applicants in Pennsylvania over a four-year period from 2005 through 2009 and discovered an error rate of 14.7 percent. That finding means that payments to nearly one in seven Medicaid applicants should not have been made, based on eligibility rules.

The state Department of Public Welfare (DPW), which is responsible for administering the Medicaid payments, reports that its own internal audits suggest a 4 percent error rate.

According to Wagner, the DPW's own admission of unwarranted payment records implies $320 million a year being spent unnecessarily.

If the error rate determined by the auditor general's office is accurate, the amount of money being misspent is more than three times higher, or close to $1 billion.

Wagner's audit suggested most improper payments have been due to the DPW failing to maintain current information regarding the eligibility status of Medicaid recipients. The DPW, according to Wagner, has failed to conduct semi-annual reviews or even annual reviews on a timely basis. This failure to monitor payments and Medicaid eligibility has resulted in people receiving benefits for which they no longer are eligible.

Fraud and waste in health care are notorious, particularly Medicare and Medicaid. A big reason for this could relate to the familiar quote from bank robber Willie Sutton, who reportedly responded to a question about why he robbed banks by saying, "Because that's where the money is."

The same can be said of health care, particularly government health care programs where fraud is estimated to be at least 10 percent of the nation's total $2 trillion annual health care bill.

Failure to adequately monitor Medicare and Medicaid is one explanation as to why losses to fraud in the government programs are higher than with private health insurance programs.

Wagner's audit suggests that Pennsylvania could reduce waste, and maybe fraud, by increasing eligibility checks.

According to a recent report in the Wall Street Journal, Medicare, which spends more than $400 billion a year, reviews only 3 percent of claims.

During the intense health care debate last fall, Sen. Patrick Leahy, D-Vt., chair of the Senate Judiciary Committee, said, "The scale of health care fraud in America today is staggering. Now, as health care reform moves through the Senate, I want to make sure we do all we can to tackle the fraud that could undermine efforts to reduce the skyrocketing cost of health care."

Most Americans would ask, "Why wait?"

The same question applies to pledges by backers of health care reform to find $483 billion in savings in Medicare spending over ten years. Again, people should ask, why wait? Cut the waste now.

Wagner's finding of lax monitoring of Medicaid payments in Pennsylvania also might relate to the fact that the federal government covers about 55 percent of Medicaid payments. Given this hefty federal subsidy, many critics suggest that states, including Pennsylvania, are less inclined to closely monitor this spending, especially since uncovering fraud and waste would result in reduced federal funding.

With Medicaid spending representing about 30 percent of state spending, and at a time when the state budget is experiencing billion-dollar shortfalls, no potential savings can be ignored — certainly not savings of $320 million a year, or more.