Johnson, Jordan Seek Information on Louisiana Medicaid Audit Showing Serious Eligibility Errors

Published: Jan 31, 2019

WASHINGTON, DC –  U.S. Sen. Ron Johnson (R-Wis.), chairman of the Senate Homeland Security and Governmental Affairs Committee, and Representative Jim Jordan (R-OH), ranking member of the House Committee on Oversight and Reform, sent a letter to the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma Thursday requesting information on a recent audit that showed 93 percent of examined Medicaid expansion enrollees in Louisiana were ineligible for services. Among the audit’s findings was that numerous beneficiaries with incomes exceeding $100,000 still received Medicaid benefits, including one with an income of $145,000. Louisiana has also relied on Medicaid expansion recipients to “self-report” changes to their wages – which auditors say may violate federal law.

In the letter, Senator Johnson and Representative Jordan ask whether CMS has inquired about the audit, what steps are being taken to recoup the overpayments, and how they are working to ensure federal Medicaid dollars in Louisiana and across the country are spent responsibly going forward.

“State auditors discovered that up to 93 percent of the expansion population they examined received Medicaid services while ineligible, including numerous beneficiaries with incomes exceeding $100,000 – far above the income permitted to qualify for Medicaid. Auditors estimated that Louisiana may have improperly paid up to $85 million,” the congressmen wrote.

“If these improper (over) payments are occurring in one state, it is logical to assume overpayments are occurring in other states. We respectfully request information about what the Centers for Medicare and Medicaid Services (CMS) plans to do to determine where overpayments are being made, steps CMS will take to recover overpayments, and controls CMS will put in place to ensure federal Medicaid dollars are only paid to those who qualify.”

Senator Johnson’s and Representative Jordan’s letter to Administrator Verma can be found here.