Missouri spent almost $100 million on the two programs from 2003 to 2004. The audit to the Department of Social Services showed Missouri was paying out too much for the Medicaid transportation contractor. The contractor earned $19 million after it was reimbursed from Medicaid recipients using taxi's or driving themselves instead of using public transportation.

"There was an incentive based in the previous contract for the provider to overcharge the state of Missouri. That's not good business," McCaskill said.

Missouri also spent more money on medical equipment than eight other states. Competitive bidding on equipment contracts, which has been tested in two other states, could save the state $5.4 million.

"It's a fairly new undertaking for states to do that. In looking at Medicaid Reform, certainly the department and the Medicaid Reform Commission will be considering some of those things," Spokesperson for the Department of Social Services Deborah Scott said.

The department has come up with a new contract for its non-emergency transportation and it's currently up for bids. McCaskill says the state always benefits from competitive bidding and needs to demand documentation of non-emergency trips so the state knows where it's money is going.