California recently agreed to repay more than $52 million after a federal inspector general determined it “improperly billed” Medicaid reimbursements to foreign nationals with “inappropriate” immigration status.[es]”
auditThe report, concluded in late May and first reported on Monday, emphasized that federal Medicaid benefits are generally limited to citizens and “qualified” aliens, such as refugees, people who have been granted asylum and people who have been admitted to lawful permanent residence.
The audit, conducted by the Department of Health and Human Services under Inspector General Christy Grimm, covered more than $372 million in federal Medicaid reimbursements paid on behalf of foreign nationals during fiscal year 2019. Of that, $52.7 million was not filed in accordance with federal requirements.
The inspector general argued that the disparity was due in part to outdated calculation standards.
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The California Department of Health Services confirmed the inspector general’s findings in a statement to Fox News Digital.
“[DHCS] We intend to repay the loan in full to the federal government by June 30, 2024,” the statement said.
“Additionally, DHCS has worked with the federal Centers for Medicare and Medicaid Services to develop and implement more sophisticated service identification methods with modern payment and billing processes.”
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Grimm’s report noted that California’s Medicaid system, Medi-Cal, offers more extensive coverage to foreigners than the federal government.
“Although Medi-Cal covers comprehensive services for UIS aliens, California can only claim federal reimbursement for emergency services provided to these aliens and generally must use state funds to pay for non-emergency services,” the report states.
“According to the Centers for Medicare & Medicaid Services (CMS), the California Department of Health Services notified CMS in May 2020 that it had used a long-standing CMS-approved methodology for billing costs to provide full-scope Medicare coverage to UIS aliens… [which] We applied a proxy percentage to capitation payments made to Medicaid managed care plans on behalf of foreign nationals with UIS.”
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The federal Medicaid agency first requested the audit, and in May 2020 the state agency told the federal government it had incorrectly claimed federal reimbursements, according to the report.
According to HealthCare.gov, undocumented immigrants are also not eligible for federal “Obamacare” insurance.
