Feds: La. must refund $7 million

Louisiana erroneously claimed more than $7 million in bonus payments related to its children’s health insurance program that need to be repaid, a federal inspector general’s report concludes.

The state Medicaid program “overstated” program enrolment, including ineligible individuals, in requests to the federal Centers for Medicare and Medicaid Services, called CMS, according to the report.

“We recommend that the state agency refund $7,124,602 to the federal government and ensure that future requests for … bonus payments include only qualifying children to comply with federal requirements,” the inspector general said.

State Department of Health and Hospitals officials concurred with the finding and promised future compliance.

DHH press secretary Olivia Watkins said the agency became aware of the “administrative error” and has corrected it.

The agency “will work closely with CMS as they determine if they agree with the report,” Watkins said. If CMS agrees with the inspector general’s finding, the state would then get instructions on how that money would be recouped, she said.

Watkins said there would be no fiscal impact to the state in the current fiscal year. “If there is a recoupment, it would most likely be reflected in (a reduction) in the October 2015 grant award for the program,” she said.

The bonus payments at issue are supposed to offset the costs of increased enrollment of children in Medicaid. Congress appropriated an extra pool of dollars when it passed the Children’s Health Insurance Program Reauthorization Act of 2009 to provide the extra funds.

In Louisiana, the program provides health care coverage to children and youths up to age 19. Eligibility depends on family income.

Louisiana has been nationally recognized for its aggressive sign-up campaign that has resulted in its rate of uninsured children dropping to about 4 percent — among the lowest in the nation.

Louisiana’s erroneous claims were made from fiscal years 2009 through 2011, according to the federal Department of Health and Human Services’ Office of Inspector General. For instance, the state claimed a current Children’s Health Insurance Program enrollment of 732,105 in 2011 when the correct number was 692,015, the performance audit report said. There were similar overstatements reported in prior years.

“If the state agency had calculated its current enrollment in accordance with federal requirements, the current enrollment would not have exceeded baseline enrollment by an amount sufficient for Louisiana to qualify for bonus payments,” the inspector general said.