The White House Office of Management and Budget has approved hiring 100 new federal employees to head off the stream of federal Medicaid dollars that go to what are known as states' "Medicaid maximization" provisions - state policies designed to expand federal financing of the program. Currently under discussion: how best to deploy the new Centers for Medicare & Medicaid Services staff members around the country, CMS Acting Deputy Administrator Leslie Norwalk told Medicaid managed-care executives Oct. 23. "It's always easier to stop a dollar going out than to collect one once it's been spent," said Norwalk. That being the case, the new hires' chief duty will be to "pre-review" state Medicaid plan amendments to nip in the bud any maximization proposals that could shift more of the Medicaid burden than federal lawmakers intend away from a state's treasury and onto the federal budget.