(The Center Square) – Virginia lawmakers are calling on federal officials to strengthen oversight of nursing home spending after a federal audit revealed millions in Medicare overpayments and lax cost reporting.

In a letter to the Centers for Medicare and Medicaid Services, Rep. Rob Wittman, R-Va., and Sens. Mark Warner, D-Va., and Tim Kaine, D-Va., urged the agency to adopt recommendations from a December 2024 audit by the U.S. Department of Health and Human Services Office of Inspector General.

Medicare spent $27.6 billion on skilled nursing care in 2019 alone, according to Stanford Institute for Economic Policy Research, accounting for nearly half of all post-acute care spending and underscoring the financial stakes as federal watchdogs push for stronger oversight.

The audit found that 7 out of 14 sampled skilled nursing facilities overstated more than $1.7 million in Medicare-related party costs — expenses tied to companies owned or affiliated with the facilities themselves.

The lawmakers also cited troubling findings from a Virginia facility, Colonial Heights Rehabilitation and Nursing Center, where the state health department previously reported cases of abuse, neglect and falsified records.

”These reports are simply heartbreaking; it is critical that our seniors receive the quality care they’ve earned and deserve,” they wrote.

The OIG recommended that CMS require Medicare contractors to review nursing home cost reports and improve guidance on what counts as an allowable expense.

However, CMS rejected the first recommendation, saying it does not have the authority to require reviews without additional funding or statutory changes.

CMS said it supports more transparency but argued it can’t carry out the recommended cost report reviews without additional funding or legislative authority.

Wittman’s letter urges CMS to reconsider and take more aggressive steps to track related-party spending. It cites a growing need for transparency and accountability in how public funds are used to support long-term care.

The OIG warned that without stronger oversight, Medicare could continue paying for services and contracts that may not be justified, putting patients and taxpayers at risk.

(The Center Square) – Virginia experienced the largest decline in employed residents nationwide in March, according to federal data that tracks where people live, not necessarily where they work.

However, economists advise that the drop may not signify a downturn in the commonwealth’s economy.

The Local Area Unemployment Statistics survey—a federal tool that measures how many residents are working—estimated nearly 15,000 fewer Virginians were employed in March. A separate federal data source, the Current Employment Statistics report, which measures jobs reported by employers within the state, showed Virginia gained about 6,000 positions.

The difference boils down to how the two surveys are designed.

“The CES data are jobs data reported by Virginia-based employers … The LAUS data provides information on the employment status of Virginia residents, wherever they work,” said David Cooper, a labor economist at the Economic Policy Institute. That distinction matters in a place where thousands of residents cross into Washington, D.C. for federal jobs.

Virginia has one of the country’s highest concentrations of federal employees and contractors, with over 144,000 residents either working in or tied to the federal workforce—many commute daily to agencies and contract roles in D.C. or Maryland.

“It’s never a good idea to look at single-month changes in either of these surveys,” said David Cooper, a labor economist at the Economic Policy Institute. “The month-to-month patterns can reverse quickly just due to noise in the data.”

Still, the March numbers stood out. Cooper said one possible explanation is that some Virginians who work in D.C. may have lost jobs while in-state employers added positions, resulting in the conflicting data.

“It’s possible that even as the number of Virginia-based jobs has grown, a larger number of Virginia residents who work elsewhere are no longer employed—which could be a result of the state’s relatively large proportion of federal workers and contractors,” he said.

Cooper also said both federal job surveys are volatile and that any conclusions about job loss or gains in March alone would be premature.

An added wrinkle: some federal workers affected by recent changes coming from the White House may still be on administrative leave, which could impact how they’re reported in the surveys.

“All that being said, I would not be surprised at all in the months ahead to see both surveys showing a decline in Virginia-based jobs and Virginia-based employment,” Cooper said.

The jobs data came out around the same time Virginia’s Department of Accounts reported a $218 million revenue drop compared to March 2024, driven largely by lower individual income tax collections.

In an effort to stabilize the commonwealth during any future economic uncertainty, Gov. Glenn Youngkin secured legislative approval to add $300 million to Virginia’s rainy day fund, bringing total reserves to about $5 billion.