Payers received billions in duplicate Medicaid payments: WSJ

Medicaid managed care insurers received at least $4.3 billion in duplicate payments for beneficiaries enrolled in multiple states between 2019 and 2021, The Wall Street Journal reported March 26.

In many cases, Medicaid beneficiaries move to another state, but do not disenroll from Medicaid coverage in their former state. Both states then pay Medicaid plans for the individual’s coverage, but the enrollee is only drawing benefits in one state, according to the Journal.

Five things to know:

1. Centene, the largest Medicaid managed care insurer, received $620 million in duplicate payments between 2019 and 2021, according to the Journal‘s analysis. Elevance Health received $346 million, and UnitedHealth Group received $298 million.
2. Rules in place during...

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