WASHINGTON--Former CMS Administrator Tom Scully said Medicaid is "managerially a mess" and that reform "is just not going to happen" because the program is too large and complex, CQ Healthbeat reported.

Speaking at the National Medicaid Congress last week, Scully said there is "not a human being in the world who knows what Medicaid is spending" due to "financing scams" states use to get extra federal matching funds. Also, "there is no federal-state partnership," added the Alston & Bird attorney.

Scully, who resigned from his CMS position in December 2003, said Medicaid programs in each state must be reformed individually, and that reducing funding as a broad measure probably would not make Medicaid more efficient. And though he does not agree with funding reductions for Medicaid, Scully said the current system is not fair because states receive different levels of federal matching funds.

Along with reform of the Medicaid program, Scully proposed increased use of health care information technology.