Many States Do Not Determine Citizenship of Medicaid Applicants, Report Finds
Most states do not perform audits to determine the citizenship status of residents who seek Medicaid enrollment, according to a report recently released by the HHS Office of Inspector General, the AP/Las Vegas Sun reports. Under federal law, individuals in most cases must have U.S. citizenship to enroll in Medicaid.
According to the report, 46 states accept a signed declaration as proof of citizenship for Medicaid applicants; Montana, New Hampshire, New York and Texas require documents to verify citizenship. Twenty-seven of the states that accept a signed declaration do not perform audits to confirm the citizenship status of Medicaid applicants, the report found. The report did not estimate the number of "noncitizens" who enroll in Medicaid.
One state, Oregon, has performed an audit to determine how many noncitizens seek Medicaid enrollment. According to the audit, 25 Medicaid applicants in a sample population of 812 did not have citizenship. Oregon officials estimated that the state would have to pay an additional $2 million in the event that 1% of Medicaid beneficiaries did not have citizenship.
Jodi Nudelman, an acting regional inspector for HHS, said, "The quality-assurance checks aren't there. That's how we see it." She added, "And it's our sense the people may not be aware of that."
However, according to CMS officials, "The report does not find particular problems regarding false allegations of citizenship, nor are we aware of any" (Freking, AP/Las Vegas Sun, 8/3).
Julie Munsell, a spokesperson for the Arkansas Department of Health and Human Services, said that, although the state does not perform audits to determine the citizenship status of residents who seek Medicaid enrollment, noncitizens likely do not receive benefits for which they do not qualify because of state rules. "I don't see it as much of an issue here in Arkansas," she said (Arkansas Democrat-Gazette, 8/4).
The report is available online. Note: You will need Adobe Acrobat Reader to view the report.