The state of California has agreed to repay over $52 million in improperly claimed Medicaid reimbursements for noncitizens with unsatisfactory immigration statuses, according to a recent audit conducted by the Department of Health and Human Services.
The audit, which covered more than $372 million in federal Medicaid reimbursements made on behalf of noncitizens during fiscal year 2019, found that $52.7 million of that sum was not filed for in accordance with federal requirements. The federal inspector general attributed the discrepancy to an outdated calculation metric.
In response to the findings, the California Department of Health Care Services plans to repay the federal government in full by June 30, 2024. The department has also worked with the federal Centers for Medicare & Medicaid Services to develop a more refined service identification methodology with updated payment and claiming processes.
The audit noted that California’s state Medicaid program, MediCal, provides wider coverage for noncitizens than the federal government. While MediCal covers full-scope services for noncitizens with unsatisfactory immigration statuses, California can only claim federal reimbursement for emergency services provided to these individuals.
Illegal immigrants are also ineligible for federal “ObamaCare” coverage, according to HealthCare.gov.
Overall, the audit highlights the importance of ensuring that Medicaid reimbursements are claimed in accordance with federal requirements to prevent improper payments and discrepancies in funding allocation.
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