Auditor Finds Health Care Waste in Minnesota

     ST. PAUL, Minn. (CN) – Though auditors hammered Minnesota for the same thing in 2014, the state’s failure to patch holes in social-services spending cost taxpayers $271 million last year, a new report finds.
     Reviewing the accounts of 157 people enrolled in state-based health insurance exchange MNsure from January 2015 through March 31, the Minnesota Office of the Legislative Auditor reported Thursday that 59 people were not eligible for the program in which they were enrolled.
     Of this group, 44 people, 28 percent of the total, were ineligible for any program, according to the 70-page report.
     Minnesota’s Medicaid program is called Medical Assistance. It and the Children’s Health Insurance Program provide low-cost or free health coverage to low-income residents.
     Low-income Minnesotans who earn too much to qualify for Medical Assistance can enroll in a third program, MinnesotaCare, through MNsure.
     The auditor found that Minnesota’s net overpayment of health care benefits cost the state between $115 million and $271 million from January 2015 through May.
     Thursday’s report on the Department of Human Services comes on the heels of a November 2014 report that also identified waste and problems with MNsure eligibility determinations.
     In addition to not ensuring Medical Assistance and Minnesota Care enrollees met the federal and state eligibility requirements, the DHS also paid benefits to ineligible people in these public health care programs, according to the report.
     Minnesota spent about $11 billion in fiscal year 2015 to pay for benefits provided under Medical Assistance and MinnesotaCare, up from $9.6 billion the year before.
     In 2015, state money accounted for $4.6 million and the federal government spent $6.4 billion on public health services.
     The report cites DHS for failing to resolve nine of 11 findings included in the 2014 report.
     Some of these unresolved findings include the DHS’ failure to accurately transfer enrollee data from MNsure to the department’s medical payment system and to detect that the staff with Office of MN.IT Services accessed personal enrollee data inappropriately.
     The DHS also failed once again to verify criteria for eligibility, such as an enrollee’s Social Security number, citizenship, income and household size, all of which resulted in ineligible individuals receiving benefits.
     The auditor also found that the DHS did not provide the county human service eligibility workers with sufficient training on MNsure, which the OLA says in a repeat finding.

%d bloggers like this: