Topline: States and the federal government spent $4.3 billion on Medicaid for hundreds of thousands of patients who were already insured in other states, according to a report from the Wall Street Journal that used data from 2019 to 2021.
Key facts: Private companies that insure Medicaid patients get paid each month for each person they cover. Patients should cancel their insurance if they move to another state and enroll in that state’s Medicaid program, often with a new insurer — but they often forget.
State governments are responsible for checking their lists and removing patients who now live somewhere else, but they fail to remove everyone. Some patients are insured in five different states at once, even though they are only receiving medical care in one state, according to the Journal.
On average, roughly three in every 1,000 Medicaid payments was for a patient no longer living in the state. Georgia’s mistake rate was twice that amount, the worst in the country.
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Between 2019 and 2021, states made duplicative payments to insurers for an average of about 660,000 patients a year, the Journal reported.
Centene, the largest Medicaid insurer, received $620 million for patients that were living in other states, the report found. Elevance Health got $346 million and UnitedHealth Group collected $298 million.
The Journal uncovered a Microsoft Teams message from a Centene employee instructing coworkers to maintain insurance coverage for patients who were known to have left the state.
“Please DO NOT close cases when you learn a member has moved out of state,” the message said. “If the member shows eligible and are out of state, they can still can [sic] utilize some of the benefits.”
A Centene spokesperson told the Journal that they are required to keep covering patients until the state tells them they are disenrolled, adding that the company repaid states about $2 billion between 2019 and 2021.
The federal government covers more than half the cost of Medicaid but relies on the states to screen for duplicate patients. However, a Florida Medicaid spokesperson told the Wall Street Journal that only the White House has “full visibility” into the duplicate enrollee data.
The inspector general for the Department of Health and Human Services recommended in 2022 that the Centers for Medicare and Medicaid Services use federal data to find double enrollees, but the recommendation was rejected, claiming its existing system is adequate.
“It should be low hanging fruit,” John Hagg, who conducts Medicaid audits for HHS, told the Wall Street Journal. “The data is there showing it is a problem. This is ripe for correction.”
Search all federal, state and local government salaries and vendor spending with the AI search bot, Benjamin, at OpenTheBooks.com.
Summary: Medicaid spending totaled nearly $890 billion in 2023. That’s plenty expensive enough without having to worry about shoddy bookkeeping among state governments.
The #WasteOfTheDay is brought to you by the forensic auditors at OpenTheBooks.com
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