Washington State Audit Questions $1B in Medicaid Spending, Might Lead to Federal Government Repayment
A Washington state audit released Thursday has cast doubt on almost $1 billion in Medicaid spending for 2005 and might lead to millions of dollars in repayments to the federal government for unauthorized medical services for undocumented immigrants, the Spokane Spokesman-Review reports (Roesler, Spokane Spokesman-Review, 4/28). The fiscal year 2005 audit, which examined the state Department of Social and Health Services and the state's $6.2 billion Medicaid program, flagged a total of 28 issues. The State Auditor's Office found that DSHS and Medicaid:
- Do not have a reliable system to identify treatments and services that are not covered by the Medicaid plan;
- Allocated federal money on services for undocumented immigrants and did not adequately review pharmaceutical claims for fraud and abuse; and
- Did not have enough internal controls to prevent Medicaid payments to dead people or people using a dead person's Social Security number.
The audit found that undocumented immigrants received coverage for prenatal care, chemotherapy, kidney transplants and other procedures that the federal government does not allow to be covered. HHS began a review of Washington's Medicaid spending on undocumented immigrants in March, but has yet to determine how much federal money, if any, should be repaid. State Medicaid Director Doug Porter said the HHS report most likely will recommend policy changes and more stringent controls on how the federal money is allocated. State Auditor Brian Sonntag said there were "[a] lot of ... repeat issues" from previous years (McGann, Seattle Post-Intelligencer, 4/28). He praised new DSHS head Robin Arnold-Williams, saying that she has made the agency much more cooperative with the auditors and that she is responsive and aggressive in trying to solve problems (Spokane Spokesman-Review, 4/28). This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
