State Auditor Again Criticizes Medicaid Eligibility Verification

The Louisiana Legislative Auditor says five of 60 Medicaid recipients it studied, or eight percent, did not qualify for the program. Auditors say the results suggest the state has been making payments on behalf of thousands of Medicaid participants who should have been ruled ineligible.

The report, released Monday, is the auditor’s second review of the Louisiana Department of Health’s eligibility verification process following the expansion of Medicaid under Gov. John Bel Edwards. As with the first report, LDH largely agreed with the auditor’s findings and recommendations and said a new eligibility-verification system will address the problems.

Auditors reviewed a sample of 60 adults who participated in the expanded Medicaid program between July 2017 and February 2018. For all 60 recipients, auditors found, LDH did not utilize federal or state tax data to verify recipients’ tax filer status and household size or to verify certain types of income, such as self-employment or out-of-state income.

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