80,000 Ineligible ACA Enrollees Cost Minnesota Millions

posted at 8:41 pm on February 10, 2016 by Kristina Ribali

Money Toilet PaperA report by Minnesota’s Office of the Legislative Auditor released last month, found that more than 80,000 Minnesotans were enrolled in Medicaid, and the state’s Obamacare exchange even though they were ineligible for the services. That incredible number of ineligible enrollees cost Minnesota taxpayers hundreds of millions of dollars.

The problems apparently stem from “miscommunication and poor training at the Department of Human Services.” However, the audit found that, “software issues” are were also blamed for the errors, which seems to be an all too standard bureaucratic excuse these days for any expensive failure within government health care programs. The Obama White House has used that same reasoning for the repeated problems with Obamacare’s enrollment and administration.

Here’s how the audit worked:

The nonpartisan Office of the Legislative Auditor took a random sample of 103 people enrolled in Medicaid and 54 people in MinnesotaCare between January and March of 2015. Auditors then used state employment data and tax returns to verify whether those individuals had actually qualified for the programs they enrolled in.

The sample was limited to people who enrolled using the MNsure software and to people who allegedly qualified for programs because of low income. That means the sample represented a population of about 270,000 people, out of more than 1 million receiving public assistance.

Of those 157 people, the audit found 38 percent weren’t eligible for their public program. Three-quarters of those people actually didn’t qualify for any program, while the remainder qualified for a different public program.

The state used this study to estimate “that between 57,000 and 108,000 people received Medicaid or MinnesotaCare benefits but shouldn’t have received any benefits at all.”

More than 100,000 ineligible recipients. Alarming to say the least.

Auditors concluded that the ineligible recipients cost taxpayers somewhere between $115 million and $271 million.

DHS Commissioner Emily Johnson Piper admitted that the report raised “serious” problems and acknowledged that the “need for improvement is critical.” She said, “Accurate eligibility determinations are a basic function that we must get right to ensure the integrity of our public health care programs.”

Republicans pounced on the news saying, “the audit vindicates what they’ve said for years: that the MNsure software is an unsalvageable mess and that Medicaid and MinnesotaCare have lots of waste, fraud and abuse.”

“We’ve spent more than $300 million on this failed Obamacare exchange, and it somehow still can’t figure out how to prevent hundreds of millions in benefits from going to those who aren’t eligible,” said Rep. Greg Davids, R-Preston, in a statement.

Other states have seen similar issues with their Medicaid rolls.

Arkansas Eligibility Issues

In 2014, the Arkansas Department of Human Services removed nearly 5,000 Medicaid expansion enrollees, representing approximately three percent of enrollment, after learning they were ineligible for benefits. The state had not bothered to verify those applicants’ eligibility before enrolling them in Medicaid. In fact, some enrollees were receiving both Medicaid and federal ObamaCare subsidies. An earlier audit found more than 12 percent of individuals in higher-cost Medicaid cases were ineligible for the program. Another 24 percent lacked appropriate documentation to establish eligibility.

Nebraska Eligibility Issues

An audit in 2013 of the Nebraska Health Insurance Premium Payment (HIPP) program—a component of the state’s Medicaid program—found that the state lacked appropriate documentation in every reviewed case file, calling into question the entirety of expenditures made under the program. More than three-quarters of the audited cases had received incorrect payments, with auditors identifying several cases of apparent fraud. One individual, for example, received more than $29,000 from the Medicaid program despite being clearly ineligible for the HIPP program. In all, state auditors found that at least a quarter of all audited expenditures were improper.

New York Eligibility Issues

A 2006 federal audit found that eight percent of New York’s Medicaid payments were made on behalf of individuals who were ineligible, but nevertheless enrolled in the program.30 Approximately 29 percent of payments were made on behalf of enrollees whose case files did not contain the required documentation supporting their eligibility determinations
A follow-up audit in 2013 found a significant number of cases for which case files had missing or invalid Social Security numbers, individuals were enrolled in the same program multiple times, or the files lacked any documentation to support the eligibility determination at all.

Ohio Eligibility Issues

A state and federal review of Ohio’s Medicaid spending in 2008 found that nearly 10 percent of Medicaid payments were improper. Nearly all of these improper payments were caused by errors and insufficient documentation in eligibility determinations.
Auditors also found a payment error rate of roughly 20 percent for Ohio’s TANF cash assistance program, caused primarily by eligibility and documentation errors. Nearly seven percent of audited payments went to individuals who were ineligible for the TANF program, while more than 13 percent went to individuals whose case files were missing the documentation required to establish eligibility.

Some States Take Action on Eligibility

Illinois, Pennsylvania, and Massachusetts have also found fraudulent beneficiaries on their books and the costs have been staggering. Nearly $1.4 billion in fraud was found between just these four states. Fortunately, some states are addressing the fraud and implementing reforms that can avert future multi-million dollar errors like this one in Minnesota.

By embracing advances in technology and e-verify software and encouraging states to monitor welfare enrollees to ensure they are still eligible to receive benefits throughout the year, states can save taxpayers billions. Modern technology should make it easy for states like Minnesota to electronically screen their list of enrollees, to ensure that they are actually supposed to be receiving the taxpayer dollars they are claiming.

Minnesota’s neighbor, Illinois has utilized similar reforms and is saving their taxpayers $350 million each year.

Luckily for Minnesota residents, some lawmakers in the land of 1,000 lakes are willing to suggest changes to their state’s welfare programs. Last year they “proposed a crackdown on waste, fraud and abuse in Medicaid and MinnesotaCare that they predicted would save the state $150 million per year.” In addition, the legislature passed a version of a bill that was projected to save $274 million – $307 million per year by improving eligibility determinations.

That’s a lot of money that could be returned to the taxpayer or put toward programs for those truly in need – not scammers and welfare fraudsters.


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Luckily for Minnesota residents, some lawmakers in the land of 1,000 lakes are willing to suggest changes to their state’s welfare programs. Last year they “proposed a crackdown on waste, fraud and abuse in Medicaid and MinnesotaCare that they predicted would save the state $150 million per year.” In addition, the legislature passed a version of a bill that was projected to save $274 million – $307 million per year by improving eligibility determinations.

That’s a lot of money that could be returned to the taxpayer or put toward programs for those truly in need – not scammers and welfare fraudsters.


Kristina
– your naivete is slightly charming but also a touch sad in this day and age.

PolAgnostic on February 10, 2016 at 8:47 PM

This is why we must elect Sanders. Once the 50%’ers finally start paying their fair share in taxes all this will be free.

Feel the Bern!

Frank Lib on February 10, 2016 at 8:50 PM

“Mistakes were made. Nobody is at fault because there is no trail of accountability. We are studying the situation. We suggest greater financial support from Congress.
“All is well. Nothing to see. Return to your huts, Comrade Citizens.”

orangemtl on February 10, 2016 at 8:58 PM

More government will fix the problem.

MichaelGabriel on February 10, 2016 at 8:59 PM

Wait, am I to understand that a huge government program is inefficient and prone to corruption? Color me shocked.

rbj on February 10, 2016 at 9:02 PM

I’m from Jersey but I’ve lived in Minnesota for the past 20 years. You guessed it, Keith Ellison’s district. This place is a cesspool of ineptitude masquerading as ‘Progressive Do-Good’. DFL legislator serves on the board of a non-profit college scholarship fund. All three of his kids get scholarships while he funnels state money to the non-profit. “I have no say in who the scholarships are awarded to”. And that’s the end of it. No investigation, no admonishment from his party, nada. Homicides in Minneapolis up 52% last year. Minneapolis Public Schools spend more per student than 98% of the districts in the state and they boast a HS graduation rate of 51% and a minority pass rate of the reading proficiency exam of 33%. Tough to get a job at McDonalds if you can’t read the menu. But they keep voting democrat because it’s Mark Dayton and we used to shop at his daddy’s store or it’s Amy Klobuchar and her daddy used to write for the newspaper. How do you think Mondale kept Reagan from sweeping all 50 states? Yep, Minnesota and DC made up his 13 electoral votes. This story about the waste in MNsure has been out for a couple of weeks but no comment from the governor, no follow-up by the press, nothing but crickets. At least in Jersey, the politicians were crooks. Here, they’re just plain incompetent, and the press is right there with them. They must all be products of the Minneapolis Public Schools.

Kidfromjersey on February 10, 2016 at 9:11 PM

A message to all states that supported ObamaCare and now regret it. Have it in ‘ya.

Mason on February 10, 2016 at 9:12 PM

Trouble they’ve found with programs to stop waste wind up costing more than the waste they recover and put back.

Example:

You have a leaky pipe that uses up 5 gallons a day at $20.

To repair the leak will cost $100,000. So that’s over a 10 years of expense.

Too long for the results to worth it for government under certain circumstances.

Politicians and bureaucrats don’t look at the long view nor are they concerned with saving taxpayers money. Unless they have a gun (of some sort) to their heads.

jake1246 on February 10, 2016 at 9:13 PM

That’s a lot of money that could be returned to the taxpayer

BWAAAAAA! In the U.S? In Minnesota? Dayton would take that money and build another choo-choo line to Farmington.

Bishop on February 10, 2016 at 9:14 PM

Luckily for Minnesota residents, some lawmakers in the land of 1,000 lakes are willing to suggest changes to their state’s welfare programs.

Yeah, ok SOMEONE is going to point this out so it might as well be me…

The schtick is that Minnesota is the “Land of 10,000 Lakes”, not 1,000. And actually there are about 15,000 lakes there. However, Florida with over 25,000 lakes kinda laughs at that…

climbnjump on February 10, 2016 at 9:20 PM

So, when we the people try to reduce how much we pay in taxes, it “costs” the government money. When people figure out how to extract money from the government through redistribution programs, it “costs” the government money.

That must mean those government workers just have to work that much harder to make up for all the “costs” exacted against the government’s money, right?

Isn’t there a way we can “cost” more of the government’s money into our pockets?

Seriously, why would anyone care how much something “costs” the government? They have a secret grove of money trees AKA Obama’s Stash anyway.

What kind of worthless loser actually cares whether the government has money or not?

The bureaucrat leeches certainly don’t care whether the people have money or not.

UnstChem on February 10, 2016 at 9:35 PM

Looks like MN needs a comprehensive reform of its healthcare system.

Oh, Wait….

BobMbx on February 10, 2016 at 9:39 PM

Cost??? What the fcuk does that mean?? We pay for it?? Make them pay the [email protected] money back!! Oh, sorry, that makes too much sense. Complete idiots…..

Indiana Jim on February 10, 2016 at 9:59 PM

Cost??? What the fcuk does that mean?? We pay for it?? Make them pay the [email protected] money back!! Oh, sorry, that makes too much sense. Complete idiots…..

Indiana Jim on February 10, 2016 at 9:59 PM

Are you saying these maggots ripping off the system are actually stealing from the people and not the government?

Every day … learn something new.

UnstChem on February 10, 2016 at 10:19 PM

None of this is an accident or oversight…these are democrat mandated give-away programs, put in place by politicians that know they’ll be looted. They’re nothing more than redistribution and reparations.

AppraisHer on February 10, 2016 at 10:44 PM

Well, it’s not the only scam going on out there of course… I was in a local tax office last week – low wall cubicles so you could hear what was going on “next door”.

There was a gal there with her 4 kids who she allowed to terrorize the office for the hour and a half that she was there. She did actually have a job and had about $28K of W2 income. But there were 2 fathers and one was completely out of the picture and the other had just taken up residence in a state prison so neither were providing any support. And she wasn’t married to either one of them anyway.

Needless to say, after deductions, exemptions and credits, she had no actual tax liability. But she was ending up with about $8k in federal refunds due to additional child tax credits and Earned Income Credit which are refundable credits. But she was not happy with all of the money she was getting back because she had also bought a house in the past year and had been told that the house was going to “pay her back big money” on her taxes when in fact the points, interest on the mortgage, deductible PMI and real estate taxes didn’t add up to more than the standard deduction for her. She was livid that she had been “misled” on buying the house.

Now, how did someone in her position actually pony up the down payment on the house? Simple. The state had given her $10k for the down payment. The state was also going to be providing ongoing assistance on the mortgage payments and the utilities. And let’s not mention that the state was also providing health care for the 4 kids.

So yup, the ungrateful woman was mad that the rest of us weren’t giving her even more money. But what would she actually do with it? Find a third father to have even more kids with?

climbnjump on February 10, 2016 at 10:46 PM

Talk to Ed. . Finland is the land of 1,000 lakes. Inflation’s hit Minnesota with their ‘Land of 10,000 Lakes’ slogan . . .

P Opus on February 10, 2016 at 11:28 PM

The Franken state. They deserve themselves.

cajunpatriot on February 11, 2016 at 6:25 AM

The dems will view this as a feature, not a bug.

The obvious corrective action, in their view, would be to eliminate qualification criteria. Free for all. Send the bill to the rich.

Daryl on February 11, 2016 at 8:22 AM

Yeah, ok SOMEONE is going to point this out so it might as well be me…

The schtick is that Minnesota is the “Land of 10,000 Lakes”, not 1,000. And actually there are about 15,000 lakes there. However, Florida with over 25,000 lakes kinda laughs at that…

climbnjump on February 10, 2016 at 9:20 PM

Actually, Minnesota only counts something as officially a ‘lake’ if it’s 10 acres or more. That results in about 11,842 lakes. Florida only has 7,700 such bodies of water.

Ricard on February 11, 2016 at 9:47 AM

the land of 1,000 lakes

It’s “The land of 10,000 lakes”, not 1,000.

Patriot Vet on February 11, 2016 at 10:47 AM

Where the hell is “Sheriff Joe”? Wasn’t he put in charge of preventing fraud?

GarandFan on February 11, 2016 at 12:24 PM

Minnesota is one of the most leftist states in the union. They deserve everything their stupidity bestows on them.

earlgrey on February 11, 2016 at 12:56 PM

The problems apparently stem from “miscommunication and poor training at the Department of Human Services.”

Bullshit, these people know damned good and well the system is being gamed because they’re part of it.

antipc on February 11, 2016 at 3:32 PM