Thousands mistakenly enrolled in California's Medicaid expansion

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From CNN Money: California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services’ chief watchdog.
In a Feb. 21 report, the HHS’ inspector general estimated that California spent $738.2 million on 366,078 expansion beneficiaries who were ineligible. It spent an additional $416.5 million for 79,055 expansion enrollees who were “potentially” ineligible, auditors found.
Auditors said nearly 90% of the $1.15 billion in questionable payments involved federal money, while the rest came from the state’s Medicaid program, known as Medi-Cal. They examined a six-month period from Oct. 1, 2014, to March 31, 2015, when Medicaid payments of $6.2 billion were made related to 1.9 million newly eligible enrollees.
There were limitations to the California review, however. The audit extrapolated from a sample of 150 beneficiaries. The authors reported a 90% confidence level in their results — whereas 95% would be more common. That meant that the number of those ineligible could have been as low as 260,000 or as high as 630,000.
“If HHS has a strong reason to believe that California is systematically making enrollment errors, it would be helpful to show that in a more robust analysis,” said Ben Ippolito, a health care economist at the American Enterprise Institute, a conservative think tank. “The federal government should ensure that states are being good stewards of federal money.”
Nonetheless, the audit highlighted weaknesses in California’s Medicaid program, the largest in the nation with 13.4 million enrollees and an annual budget topping $100 billion, counting federal and state money. Medicaid covers one in three Californians.
The inspector general found deficiencies in the state’s computer system for verifying eligibility and discovered errors by caseworkers. The Medicaid payments cited in the report covered people in the state’s fee-for-service system, managed-care plans, drug treatment programs and those receiving mental health services.
California’s Department of Health Care Services, which runs Medi-Cal, said in a statement that it agreed with nearly all of the auditors’ recommendations and that the agency “has taken steps to address all of the findings.”
In a written response to the inspector general, California officials said several computer upgrades were made after the audit period and before publication of the report that should improve the accuracy of eligibility decisions.
Among the 150 expansion enrollees analyzed in detail, 75%, or 112, were deemed eligible for the Medicaid program in California. Auditors discovered a variety of problems with the other 38 enrollees.
During the audit period, 12 enrollees in the sample group had incomes above 138% of the federal poverty line, making them ineligible financially for public assistance, according to the report.
In other instances, beneficiaries were already enrolled in Medicare, the federal health insurance for people 65 and older or who have severe disabilities, and did not qualify for Medi-Cal. Onewoman indicated she didn’t want Medi-Cal but was enrolled anyway.
In 2014, the state struggled to clear a massive backlog of Medi-Cal applications, which reached about 900,000 at one point. Many people complained about being mistakenly rejected for coverage, or their applications were lost in the state or county computer systems.
California was one of 31 states to expand Medicaid under the 2010 Affordable Care Act. The health law established a higher federal reimbursement for these newly eligible patients, primarily low-income adults without children. After expansion started in 2014, the HHS inspector general’s office began reviewing whether states were determining eligibility correctly and spending taxpayer dollars appropriately.
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0 responses to “Thousands mistakenly enrolled in California's Medicaid expansion

  1. How much of that money is sent back to mexico or spent on drugs? Is there any wonder people are leaving in droves. The progressives have destroyed that state and now coming soon to your state progressive thinking. They should flush there minds. And get a real brain. If people can’t see what is happening there then God help us they are brain dead as well.

  2. Reblogged this on kommonsentsjane and commented:
    Reblogged on kommonsentsjane/blogkommonsents.
    Obama holdovers signed up all of the ineligible people (catch me if you can illegals) for insurance coverage and then you wonder why our country’s debt if beyond reasonable means. It is time to cut the apron strings and make everyone “re-apply.” Under the Obama administration the system was hijacked and we don’t know where the money went. We cannot depend on CA for anything because their system is broken.

    • kommonsentsjane . . . . Your suggestion is truly brilliant. Let all recipients of Medi-Cal “re-apply” for benefits. Those who do apply should immediately be audited by Federal workers to make sure that anyone who applies actually is entitled to benefits, and to STICK THEIR HANDS IN THE POCKETS OF THE AMERICAN TAXPAYER
      I am in a quandary . . . since this audit shows such glaring amounts of mistakes on the part of California public servants — how many illegal immigrants are on these rolls? I have little doubt but what it is a huge amount. If the Federal audit team can determine that Mexican nationals are indeed signing up to embezzle monies from you and I, as American Taxpayers . . . then ICE agents should be sent out and any who are here illegally should be put into the “Return to your own homeland program.”
      After reading this article, which is the first one I have read this morning . . .I find that I rather have my dander up!!!!! In previous times in the history of our nation, those who came here brought needed skills, and they were willing to work like dogs to achieve for themselves and their families. Now we have persons who are the lowest educated, non-skilled individuals who are only fit to suck up the various Welfare benefits. They contribute very little of true excellence to our country. I just read an article based on statistics regarding these illegal immigrants . . . only TWO PERCENT of the total amount of these illegals are involved in the “picking and harvesting of American farm crops.” Yet, when we hear liberals, we would be lead to believe that 98% of these folks are harvesting our crops. It would seem that the only thing they are harvesting is American dollars which you and I were forced to relinquish to the US government.

  3. I thought California was the most prosperous state. The media tells me this all the time. If so, how can 1/3 of it’s population be eligible for insurance for the poor? Add on those with subsidized Obama Care, and you have a disaster waiting to happen. I wonder how many of the medicaid recipients are illegal aliens?

    • Patrick Dykie . . . . Please forgive me, I asked the same question above. I had not yet read your submission to this article. I think that the question of how much of our Federal dollars are being spent on those who have no legal right to reside within our boarders is a question that is paramount.
      It sickens me that Federal funds are being transferred to illegals . . . yet our elderly often live in want; our ex-military personnel often are found to be on the streets. Do we not have enough indigent to be found among legal United States citizens? I rather think so.

  4. Under Obama the number of people enrolled in Medicaid in California increased from FIVE million to TWELVE million. Any warm body
    was accepted. Many still find it hard to get care because of a
    lack of medical providers. HMOs are overflowing with patients.
    For example, Kaiser South bay facility in Harbor City, Ca.
    almost doubled the number of Kaiser members without
    expanding its facilities before adding these new members.
    Parking garages are jammed. ER and urgent care waits
    can be hours. When the Fed can no longer print money out
    of thin air, this welfare bubble will collapse. California is
    not the Golden State any longer; it is the suicide state.

    • Gary . . . . God Bless you for pointing out the obvious. I wonder how members of Kaiser feel with the services they are receiving when they pay either through employer paid medical insurance, or are funding their own medical services.
      It is outrageous what is going on in California . . . and it is being paid for with dollars contributed by taxpayers.

  5. Meanwhile, tens of thousands of Medicaid recipients don’t even pay their premiums.

  6. We need to kick califailure out of the US. crap like this is dragging us down.
    See how long they can last without fed dollars. Where’s the box I can check to opt out of paying for this?

  7. When you couple this with the fact that in the last year they have given driver licenses to over 1M new applicants (which entitles them to vote unless they specifically decline), you’ve got yourself trouble.
    All this largesse comes from somewhere. A lot of it is federally subsidized. Then they have the effrontery to refuse to assist federal agents in the enforcement of federal laws. Oh, but keep that money coming in.

  8. Goodness what a mess, but a perfect way to launder money. We have no idea who is getting what who is legal or illegal. Withhold all funds until a fiscal audit is done.

  9. What’s wrong with annual or whatever re-application? Ditto that for DACA recipients. It would catch those who never actually should have received it in the first place, while extending it to those who truly deserve it. Other program beneficiary recipients have to re-apply for their benefits… those who are actual US citizens, at that. There are actually people receiving gov’t benefits who have been DEAD a while (or returned to their home country?)
    But I’m willing to bet that the left would find that idea abhorrent. And yes, I had to spell check that word.
    Speaking of things the left finds abhorrent — that seem perfectly reasonable to me — why are they having such conniptions over Sinclair Broadcasting’s decision to have their newscasts adhere to a policy of avoiding fake, biased, opinion-as-news? I actually stood up and clapped in my house when I heard my local anchors reading the script last week. I couldn’t even tell they were “attacking” the left… it sounded right down the middle. Dr. Eowyn? Anybody?

  10. I don’t think this was a mistake at all. One of the steps of destruction is bankrupt the system.

  11. No mistake when left/libtards are trying to expand single-payer.


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