The Department of Health and Human Services recently released an audit which says that almost $72 million in Medicaid payments were given to ineligible people in Kentucky. The state didn’t determine the eligibility status for Medicaid benefits and the agency didn’t keep paperwork about citizenship status.
Although states must verify the citizenship status of the people who want to receive Medicaid benefits, Kentucky determined the eligibility status for Medicaid benefits without any documentation.
Free Beacon reports: “The state agency did not always meet Federal and State requirements when making eligibility determinations because of both human and system errors,” the report states. “The state agency did not always perform, or maintain documentation that it had performed, identity-proofing because of both human and system errors related to processes implemented in response to the ACA that affected eligibility determinations for non-newly eligible Medicaid applicants.”
If a person applies for Medicaid benefits through the state marketplace, the person must go through identity-proofing. Although the person should give their birth date and Social Security number during the application, the audit discovered that the state didn’t provide documentation for 13 beneficiaries.
“On the basis of our sample results, we estimated that during our 6-month audit period, approximately 8 percent of non-newly eligible beneficiaries in Kentucky were potentially ineligible, and approximately 3 percent of federal payments were made to those beneficiaries,” the report states. “As a result, we estimated that Kentucky made federal Medicaid payments on behalf of 69,931 potentially ineligible beneficiaries totaling $72,763,721,” Free Beacon reports.
The auditors and the state agency suggested Kentucky provide the documentation that shows verified citizenship and identity. As indicated by Stephen Miller, the commissioner at the state agency, the Kentucky Department for Medicaid Services admitted that mistakes were made.
Free Beacon reports: “When informed of the issue, the Department for Medicaid Services utilized staff communications and training to reinforce correct procedures. The state appreciates the opportunity to comment on your recommendations,” Miller said. “We believe the issues identified have been successfully corrected.”
It is not ok that some people pay for Medicaid benefits while others don’t and still receive it. Hopefully, Kentucky will correct this mistake soon.