The federal Medicaid agency described a November audit that said Louisiana’s Medicaid expansion program may have spent as much as $85 million on ineligible enrollees as “deeply troubling” and said it could seek repayment of misspent money.
The U.S. Centers for Medicare and Medicaid Services said it will include Louisiana in a future review of how “high risk states” determine eligibility for government-financed Medicaid benefits, in response to work done by Louisiana Legislative Auditor Daryl Purpera.
But the federal agency, known as CMS, also noted a computer system change launched by Gov. John Bel Edwards’ administration after Purpera’s audit. The Louisiana Department of Health now does quarterly eligibility checks, rather than previously performed annual checks, and uses more wage data for comparison.
“As we understand, recent upgrades to Louisiana’s eligibility systems will help to address some of the issues identified,” CMS Administrator Seema Verma wrote in a March 8 letter to U.S. Sen. Ron Johnson, a Wisconsin Republican and chairman of a Senate oversight committee.Verma’s letter, provided to The Associated Press by Purpera’s office, came in response to concerns Johnson and U.S. Rep. Jim Jordan of Ohio, the top Republican on a House oversight committee, raised in January about Purpera’s audit.
Though the federal Medicaid agency has limited legal authority to seek return of overpayments made through eligibility mistakes, Verma wrote that it can recoup misspent federal funds from states through a “disallowance” in certain circumstances. Read the full story.