California recently agreed to repay more than $52 million that a federal inspector general said was an “improper claim” for Medicaid reimbursements for “noncitizens with suboptimal immigration status.”[es]”.
An audit that concluded in late May but reported for the first time on Monday highlighted that federal Medicaid benefits are generally limited to citizens and “eligible” non-citizens. Examples of qualified non-citizens include refugees, persons granted asylum, or persons lawfully granted permanent residence.
The audit, led by Department of Health and Human Services Inspector General Christi Grimm, covered more than $372 million in federal Medicaid reimbursements paid on behalf of noncitizens in fiscal year 2019. A total of $52.7 million of this amount was not reported in fiscal year 2019.
The inspector general blamed the discrepancy in part on outdated calculation metrics.
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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] The plan is to repay the federal government in full by June 30, 2024,” the statement read.
“In addition, DHCS is working with the Centers for Medicare and Medicaid Services to develop and implement improved service identification methods and updated payment and claims processes.”
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Grimm’s report noted that MediCal – California’s Medicaid program – has broader coverage than the federal government when it comes to non-citizens.
“Although MediCal covers the full range of services provided by UIS to noncitizens, California may require federal reimbursement only for emergency services provided to these noncitizens and generally requires the use of state funds to pay for non-emergency services,” the report states.
“According to the Centers for Medicare and Medicaid Services (CMS), in May 2020, the California Department of Health Care Services notified CMS that it had been using a long-standing, CMS-approved method to handle the cost of providing comprehensive care. Claim. [which] A proxy percentage is used for capitation payments to Medicaid managed care plans on behalf of UIS noncitizens.
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The federal Medicaid agency reportedly first requested the audit, and in May 2020, the state agency told the federal government that it had mistakenly claimed federal reimbursement.
According to HealthCare.gov, illegal immigrants are generally not eligible for federal “Obamacare” insurance.
