U.S. taxpayers spent at least $4.3 billion over a three-year period covering the same Medicaid patients twice or more, The Wall Street Journal reported.
Medicaid paid health insurance companies for hundreds of thousands of patients who signed up for the program in two or more separate states. This happened when a patient moved to a different state, but Medicaid continued paying the insurance company in the state where the resident previously lived, the March 27 story stated.
Medicaid is a joint state and federal health insurance program for the poor. Medicaid pays private insurance companies for each person covered. However, a person isn’t supposed to be covered in a state after moving out.
Pandemic Payment Problems
The Journal reported that from 2019 to 2021—which included the COVID-19 pandemic—duplicate payments for an average of about 660,000 patients per year totaled $4.3 billion, and more than 270 Medicaid insurers collected duplicate payments.
Medicaid paid Centene $620 million in duplicate payments between 2019 and 2021, and Elevance Health collected $346 million from duplicate Medicaid payments, the newspaper reported. Medicaid paid UnitedHealth Group $298 million.
“Paying for a beneficiary’s Medicaid coverage in one state when that individual is already enrolled in a different state is a prime example of taxpayer dollars being mismanaged,” a spokeswoman for the federal Centers for Medicare and Medicaid Services told the Journal.
The agency will work with states to address the matter, the spokeswoman said.
President Donald Trump’s nominee to run the federal agency, Mehmet Oz, has said he will rein in large payments to private insurers.
An insurance industry group executive responded[as1] to the findings.
“It’s a heavily regulated industry,” Craig Kennedy, chief executive of Medicaid Health Plans of America, told the Journal. “Following rules and regulations is the No. 1 priority here.”
Fred Lucas ([email protected]) is the chief news correspondent at The Daily Signal.
This article was published previously by The Daily Signal. Reprinted with permission.
