California agrees to repay feds $52M in ‘improperly claimed’ immigrant Medicaid disbursements
Fox News
The state of California recently agreed to repay more than $52 million in what a federal inspector general determined were “improperly claimed” Medicaid reimbursements for “noncitizens with unsatisfactory immigration status[es].”
An audit, concluded in late May but first reported Monday, underlined that federal Medicaid benefits are usually limited only to citizens and “qualified” noncitizens. Examples of qualified noncitizens are refugees, people granted asylum or those lawfully admitted for permanent residence.
The audit, conducted by the Department of Health and Human Services under Inspector General Christi Grimm, covered more than $372 million in federal Medicaid reimbursements made on behalf of noncitizens during fiscal year 2019. A total of $52.7 million of that sum was not filed for in accordance with federal requirements.
The inspector general in part blamed an outdated calculation metric for the disparity.
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In a statement to Fox News Digital, the California Department of Health Care Services acknowledged the inspector general’s findings.
“[DHCS] plans to repay the federal government in full by June 30, 2024,” the statement read.
“Additionally, DHCS has worked with the federal Centers for Medicare & Medicaid Services to develop and implement a more refined service identification methodology with updated payment and claiming processes.”
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Grimm’s report noted MediCal – California’s state Medicaid program – casts a wider coverage net than the federal government when it comes to noncitizens.
“Although MediCal covers full-scope services for noncitizens with UIS, California may claim federal reimbursement only for emergency services provided to these noncitizens and would generally need to pay for nonemergency services using state funds,” the report said.
“According to the Centers for Medicare & Medicaid Services (CMS), in May 2020, the California Department of Health Care Services notified CMS that it had been using a longstanding, CMS-approved methodology related to claiming costs for providing full-scope Medi-Cal coverage to noncitizens with UIS… [which] applied a proxy percentage to capitation payments made to Medicaid managed care plans on behalf of noncitizens with UIS.”
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The federal Medicaid agency first requested an audit, and in May 2020, the state agency told the feds it had erroneously claimed federal reimbursement, according to the report.
Illegal immigrants are also ineligible overall for federal “ObamaCare” coverage, according to HealthCare.gov.