California to Repay Federal Government $52M in ‘Improperly Claimed’ Immigrant Medicaid Payments

The state of California has agreed to repay the federal government over $52 million following an investigation which determined that there were “improperly claimed” Medicaid disbursements to “noncitizens with unsatisfactory immigration status[es].”

As Fox News reports, the payment will be made following an audit by Inspector General Christi Grimm of the Department of Health and Human Services (HHS), which concluded in May and issued its official report on Monday. The audit covered over $372 million in federal Medicaid reimbursements in Fiscal Year 2019, and discovered that at least $52.7 million of that amount was not filed in accordance with federal guidelines.

In California, federal Medicaid payments are allowed for “qualified” illegal aliens, such as refugees, people granted asylum, or people who have been admitted for permanent residence. The $52.7 million was sent to illegals who did not qualify for any of these categories.

The California Department of Health Care Services issued a statement acknowledging the inspector general’s findings, stating that “[DHCS] plans to repay the federal government in full by June 30, 2024.”

“Additionally, DHCS has worked with the federal Centers for Medicare & Medicaid Services to develop and implement a more refined service identification methodology with updated payment and claiming processes,” the statement continued.

Grimm’s report pointed out that MediCal, the state-level program for Medicaid in California, has a wider coverage net for illegals than the federal government does. But she ultimately placed blame on the state government’s use of an outdated calculation metric.

“Although MediCal covers full-scope services for noncitizens with UIS, California may claim federal reimbursement only for emergency services provided to these noncitizens and would generally need to pay for nonemergency services using state funds,” the report detailed.

“According to the Centers for Medicare & Medicaid Services (CMS), in May 2020, the California Department of Health Care Services notified CMS that it had been using a longstanding, CMS-approved methodology related to claiming costs for providing full-scope Medi-Cal coverage to noncitizens with UIS,” Grimm continued, “[which] applied a proxy percentage to capitation payments made to Medicaid managed care plans on behalf of noncitizens with UIS.”

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About Eric Lendrum

Eric Lendrum graduated from the University of California, Santa Barbara, where he was the Secretary of the College Republicans and the founding chairman of the school’s Young Americans for Freedom chapter. He has interned for Young America’s Foundation, the Heritage Foundation, and the White House, and has worked for numerous campaigns including the 2018 re-election of Congressman Devin Nunes (CA-22). He is currently a co-host of The Right Take podcast.

Photo: Los Angeles, CA - January 03: Governor of California Gavin Newsom speaks during a press conference on Wednesday, January 3, 2023, at the Los Angeles General Medical Center to urge support for Proposition 1 on the March 5, 2024 ballot. The proposition would overhaul California's mental health funding system, and a $6.4 billion bond will expand access for hundreds of thousands of Californians, fund substance abuse treatment, and help get those suffering from mental health crises off the streets and into care. (Photo by Hans Gutknecht/MediaNews Group/Los Angeles Daily News via Getty Images)

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