Audit: Louisiana Department of Health paid $113 million to Medicaid recipients living outside of state
BATON ROUGE, La. (BRPROUD) -- Thousands of people who no longer live in Louisiana got Medicaid payments, audit findings released Monday show.
Auditors suggested that the Louisiana Department of Health improve its process for identifying Medicaid recipients who aren't living in the state anymore and don't qualify for the program.
The report said $112.6 million in monthly payments were made by LDH to 13,771 adult recipients who are no longer Louisiana residents. These individuals were reportedly identified as living in another state because their addresses were changed to out-of-state addresses in LDH's Medicaid system or they had gotten a driver's license in another state.
The audit said LDH paid $3 million in per-member per-month payments to 380 people identified as living out of state from June 2019 through February 2023 and $109.5 million went to 13,391 people who had gotten driver's licenses in other states from September 2016 to February 2023.
"According to LDH, it could not terminate the Medicaid coverage of these beneficiaries during the COVID-19 Public Health Emergency (PHE) unless certain criteria was met due to the possibility that the Centers for Medicare and Medicaid Services (CMS) would end Louisiana’s Families First Coronavirus Response Act Federal Medical Assistance Percentage match increase," auditors said.
In a response letter, LDH Secretary Stephen Russo said CMS guidance during COVID said states couldn't drop anyone without specific confirmation from them that they no longer live in the state. He said they couldn't use previous methods to determine a move, like returned mail.
Russo said LDH plans to confirm out-of-state addresses and close flagged cases in a timely manner.
Click here to see the full audit.