Tuesday, October 10, 2017

Audit: Washington needs to verify Medicaid incomes sooner or risk losing $110 million by 2020

Posted By on Tue, Oct 10, 2017 at 1:02 PM


A backlog created by more people signing up for Medicaid insurance coverage has meant that people who weren't actually eligible for coverage received it for an average of five months before their income was verified by a state agency, according to a recent report by the Washington State Auditor.

A performance audit of Washington's Health Care Authority found that the state could save millions by verifying self-reported income levels sooner, and booting those who don't qualify off the free coverage faster, but it will take more staff members to do so.

Part of the reason a backlog was created is that when Medicaid coverage was expanded to more low-income people under the Affordable Care Act in 2014, the state authority did not hire a proportional number of additional employees to help verify income, according to the report. While the state expected that another 237,000 adults would enroll that year, the state actually saw an additional 511,000 sign up.

This June, the state had a backlog of 112,000 cases to verify, the audit reports, and for fiscal year 2017, "HCA purchased about $15 million to $19 million in state-funded benefits for people who ultimately did not qualify, which could have been avoided with adequate staffing."

Some verification processes have already been improved, and should decrease the backlog of cases, according to the audit, but it could take four years to get through all current cases.

But if the Legislature were to approve additional verification employees starting next summer, as the audit recommends, the state could get through the backlog by spring of 2019 and save $13 million, even after the costs of paying for the new employees.

"Unless [HCA] hires 30 more verification staff and additional managers to supervise them, HCA will spend an estimated $110.2 million more on Medicaid benefits for people with ineligible incomes for the two years ending June 2020," the audit found.
 
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