The Bush administration has singled out 15 states that it claimed used improper accounting methods to garner excessive amounts of federal Medicaid money. Officials claimed that Alabama, Alaska, California, Georgia, Idaho, Illinois, Iowa, Massachusetts, Minnesota, Mississippi, North Carolina, North Dakota, Tennessee, Virginia and Washington all have been recycling federal monies rather than using both state and local tax revenue to pay their share of Medicaid costs. According to reports, Secretary of Health and Human Services Michael O. Leavitt had often charged that select states have used improper accounting techniques or "gimmicks" to shift the costs of Medicaid to the Treasury.

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