Health Payer Intelligence June 21, 2019
CMS set new integrity guidelines and warned states of future audits on Medicaid eligibility determinations.
The Centers for Medicare & Medicaid Services (CMS) released renewed guidance on Medicaid eligibility determinations and spending integrity the organization announced.
According to CMS, Medicaid eligibility for adults in expansion states are not being assessed within federal and state requirements in some states. The failure to correctly identify eligible and ineligible individuals could result in additional Medicaid costs.
“We have seen a rapid increase in Medicaid spending in recent years and with this growth comes an increasing and urgent responsibility to ensure sound stewardship and oversight of our program resources,” CMS Administrator Seema Verma stated.
The organization’s new guidance emerges after Office of Inspector General...
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