News: OIG audit finds four states inappropriately terminated Medicaid enrollees during COVID-19

A recent audit conducted by the Office of the Inspector General (OIG) has found that four states—Texas, Florida, Minnesota, and New York—terminated Medicaid coverage for thousands of enrollees during the COVID-19 pandemic.

The audit was conducted to review the increase in funding these states received because of the “Families First Coronavirus Response Act.” As part of this policy, each state received a 6.2% increase to their regular federal medical assistance percentage (FMAP) to assist with the containment, treatment, and public health coordination of coronavirus.

In total, each state received $12.8 billion from January 1, 2020, through June 30, 2021.

After reviewing the evidence, the OIG concluded that all four states “did not meet all of the requirements to receive the increased COVID-19 FMAP.”

In particular, New York, Florida, Texas, and Minnesota, had terminated Medicaid enrollees for unallowable reasons or could not provide documentation that it had done so for allowable ones. Additionally, the OIG noted that Minnesota had inappropriately charged cost-sharing for COVID-19 testing, services, and/or treatment.

In its recommendations, the OIG stated that the Centers for Medicare & Medicaid Services should (1) work with the four states to determine what amount of the COVID-19 FMAP funding should be refunded to the federal government, and (2) work with Minnesota to determine which enrollees should be refunded and to what degree.

Editor’s note: Read the full OIG report, here.