Feds Increase Oversight of Medicaid Enrollment, Managed Care Plans

The CMS is ratcheting up scrutiny of state Medicaid programs.The agency announced Tuesday that it is boosting audits to confirm that Medicaid beneficiaries are correctly identified as expansion or pre-expansion enrollees. States receive higher federal match rates of around 90% for expansion enrollees, while the match rate can be as low as 50% for pre-expansion enrollees.

"This imbalance in the federal matching rate creates financial risks for taxpayers by incentivizing states to shift cost to the federal government," CMS Administrator Seema Verma told reporters Tuesday. "This requires us to make sure that states are making accurate eligibility determinations."

The CMS also said it will audit states found by HHS' Office of Inspector General to be at high risk for enrolling ineligible people