Audit Finds Thousands of Errors in Idaho’s Medicaid Eligibility System
The Idaho Department of Health and Welfare's Medicaid eligibility system contains thousands of errors because of the lack of coordination between the automated computer system used to determine Medicaid eligibility and the computer system used to process payments, according to a state audit released on Thursday, the AP/Spokane Spokesman-Review reports. The state Legislative Services Office first recommended the department reconcile the two systems in 2003. According to the audit, "The last completed reconciliation was for a 13-month period and contained 23,240 errors." More than 1,500 errors were corrected within five weeks, but more than 21,600 remained. "Based on these numbers, we estimate 400 errors and only 300 corrections occur each week, resulting in approximately 100 new errors that will not be corrected."
According to the auditors, because the systems have not been reconciled, some individuals' access to Medicaid is being delayed or is not being established. If the department does not completely develop and integrate the systems, the state's Medicaid program could face federal sanctions, auditors said.
Emily Simnit, a spokesperson for the department, said that the audit was based on old information and that the department has since collected documentation to give to CMS showing that it is addressing the problem. Simnit said that most of the errors "haven't impacted real people in real situations. And the ones that do have an impact on payment and eligibility, those are prioritized at the top of the list." Both computer systems are scheduled to be replaced next year and the department is working on a reconciliation process for the new programs, Simnit said (Boone, AP/Spokane Spokesman-Review, 11/21).
