IG Report Exposes Possible Medicaid Fraud in California – Is the State Funding Illegal Immigrants?

Even The People’s Republic of California has to face reality sometimes.

As in, how to pay for all the benefits they’re giving to their welcome guests that less enlightened people call “illegal immigrants.”

One way they’ve done it is by using wrong methods to claim Medicaid payments.

Maybe deliberate, maybe just convoluted bureaucratic operating, but a recent federal audit by the Department of Health and Human Services Office of the Inspector General showed California used wrong methodology in accounting for nearly $53 million in Medicaid benefits for – as the audit put it – “noncitizens with unsatisfactory immigration status.”

The federal government does not allow Medicaid reimbursements to the states for treatment of illegal aliens, except emergency services to legally-admitted non-citizens and certain refugees.

Even then, in some cases a five-year waiting period is in effect.

California, according to the audit, filed reimbursement for nonemergency treatment of those UIS people. That money should have come from the state’s funds, the report said.

Join me in the weeds for a bit as we look at a portion of the audit report: “Of the $372.9 million in total Federal Medicaid reimbursement for capitation (reimbursement) payments made on behalf of noncitizens with UIS, California did not claim $52.7 million in accordance with Federal requirements.”

“California improperly claimed $52.7 million in Federal Medicaid reimbursement because it continued to use the proxy percentage that was developed in the early 2000s without assessing whether the percentage correctly accounted for the costs of providing nonemergency services to noncitizens with UIS under managed care.

“In addition, California did not have any policies and procedures for assessing and periodically reassessing the proxy percentage.”

I warned you about the weeds.

But it’s like this: California — whether accidentally or deliberately — used the wrong procedures to make its Medicaid reimbursement claims, resulting in $52.7 million in improper claims.

That’s irritating. But there’s more. The audit described federal funds totaling $372.9 million authorized to provide emergency treatment to illegal aliens.

A third of a billion dollars pumping up our deficit to care for people who may or may not be concerned with contributing to as opposed to taking from the United States?

And yet …

There’s a bit of the American — and Christian — spirit embedded in this.

If a foreigner in this country is need of emergency treatment, the tradition has been to take care of them, then worry later about billing.

Same with a citizen.

Sometimes health providers will write off the costs of aiding someone in need who is unable to pay.

But that can’t go on indefinitely.

And too many have taken advantage of those extensions of charity which have resulted in hospitals being overwhelmed.

And the problem is growing.

The fact that the federal government has set aside so much money to treat the unsatisfactory immigration status people among us is one more symptom pointing to a serious problem.

For its part, California is not denying the accusation it took an unauthorized $52.7 from the feds; it’s negotiating a means of repayment.

But the rest of us have to say — when will the insanity stop?