MARYLAND (WBFF) — A recent audit of the Maryland Department of Health revealed numerous issues related to Medicaid payments, including millions of dollars in payments for individuals who were ineligible, incarcerated or dead.
The audit of the Maryland Department of Health Medical Care Programs Administration, which administers Medicaid, found that they “did not have effective processes to identify, prevent, and recover questionable Medicaid payments including $9.2 million in payments on behalf of recipients who were incarcerated or deceased at the time of service.”
According to the audit, in 2024, the MCPA paid about $2.3 million for individuals who were ineligible based on the documentation provided. It also found that they “did not ensure that Medicaid recipients age 65 or older had applied for Medicare, potentially resulting in the State paying for services that should have been covered by the federal government.”
Some issues acknowledged in the most recent audit had come up in previous audits, but were not properly corrected. For instance, the audit found that continued stay reviews for recipients in nursing facilities were not completed, “resulting in a lack of assurance that the associated payments totaling $338.3 million were proper.”
The audit also showed that MCPA did not approve home and community-based services in a timely manner, resulting in recipients either not receiving required services, or payments being made for services that were no longer necessary.
While officials with the Department of Health were generally agreeable with the recommendations provided in the report, in a response, Meena Seshamani, the Secretary of the Maryland Department of Health said, “as written, the report does not sufficiently distinguish between unresolved compliance failures and issues already actively remediated or substantially corrected prior to issuance. In several instances, the report also does not adequately reflect the operational complexities associated with administering one of the State’s largest and most federally regulated programs during a period of significant system modernization and transition.”
“Additionally, the Department has significant concerns regarding aspects of the audit methodology and resulting characterization of MCPA’s operational performance,” she continued to say. “The Department is concerned that the report does not consistently account for corrective actions already implemented prior to report issuance or provide sufficient transparency regarding how progress toward remediation is evaluated and reflected in final audit determinations.”
In a statement to FOX 45, a spokesperson from the Maryland Department of Health said, “it is important to note that MCPA has already fully resolved nearly half of the findings identified by auditors – including two repeat findings – and will complete most corrective actions for the remaining findings this year.”
“It looks like we are entering another season of terrible audits,” said House Minority Leader Jason Buckel. “Governor Moore and the leaders of his agencies have had ample opportunity and years to implement reforms, strengthen oversight, and ensure accountability. Instead, Maryland taxpayers are being dealt a pattern of repeated failures across multiple agencies, which has become impossible to ignore.”
While the Governor’s Office deferred to the Maryland Department of Health for specifics related to the Medicaid audit, a statement from Rhyan Lake, a Senior Communications Strategist, said, “Governor Moore believes fiscal discipline is a critical priority and is dedicated to ensuring the responsible stewardship of Maryland’s taxpayer dollars. Though more work remains to resolve longstanding issues with Maryland’s fiscal management systems, the Moore-Miller administration is committed to our ongoing partnership with the General Assembly to strengthen our state’s financial structures.”
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