Audit: Louisiana spent $112 million+ on Medicaid for people who don’t live in Louisiana

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In one case, LDH spent $102K on someone with a New York driver's license who received no medical care.



The Louisiana Department of Health spent $112 million on Medicaid coverage for nearly 14,000 adults who don't appear to live in Louisiana, according to a state legislative audit released Monday.

The payments, made from September 2016 through February of this year, violated state policies: To receive Medicaid coverage in Louisiana, a person must be a Louisiana resident.

The audit found that the incorrect payments were largely "per-member, per month" payments made to so-called "managed care entities." Essentially, that means the health department was reimbursing health care providers for treating patients enrolled in Medicaid through the state of Louisiana who were not living in the state at the time.

In some cases, auditors found that Medicaid beneficiaries had been auto-enrolled in Medicaid because they were Supplemental Security Income recipients or had qualified for other Medicaid programs. In reviewing case files for these people, they found some cases where "there was little or no record of contact made with the Medicaid beneficiaries, indicating they may not have even known they were enrolled in Medicaid," the report says.

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