Oregon may be paying $37 million per month in Medicaid benefits for ineligible beneficiaries, according to Oregon Secretary of State auditors.
Secretary of State Dennis Richardson said more than 86,000 individuals, or 8 percent of Oregon's Medicaid recipients, did not undergo the annual benefit eligibility determination process required by the federal government. Roughly 14,000 of those individuals did not return Medicaid applications, despite being sent renewal notices.
Mr. Richardson said a "preliminary analysis did not clearly identify why the remaining 71,600 have not been redetermined," according to an Auditor Alert filed May 17. He added the issue has been ongoing for the past three years and "may place federal funding to Oregon in jeopardy and result in a misuse of state monies," Portland Business Journal reports.
The Oregon Health Authority disputed the audit, arguing it included "preliminary information and does not provide the entire context" of the Medicaid eligibility and renewal process, the report states. OHA officials also said it is still transferring some beneficiaries from the state's failed Cover Oregon system to the new Medicaid program. The move is expected to reach completion by the end of May.
Mr. Richardson recommended OHA "work with the federal regulatory authorities to ensure federal Medicaid funding is not jeopardized while OHA resolves these eligibility determination issues." He also asked OHA to "report on its efforts to resolve these issues and fiscal impacts to the legislature no later than September 30, 2017."