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California Wrongly Claimed Millions in Medicaid Services for Illegal Migrants: HHS Watchdog Reports

The office alleged that the State of California improperly claimed about $52.7 million in federal Medicaid reimbursements. The Biden administration has plans to allow as many as 100,000 uninsured illegal immigrants to access taxpayer-funded health insurance.
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The state of California incorrectly claimed millions of dollars in federal Medicaid funding for health services that were provided to illegal immigrants, according to the Department of Health and Human Services Office of Inspector General .

The OIG released an audit last month that alleged the California Medicaid program didn't use proper methodology to evaluate reimbursements for resources given to noncitizens who aren't eligible to be fully covered by Medicaid.

"States are generally prohibited from claiming Federal reimbursement for Medicaid services, other than treatment of an emergency medical condition, provided to certain noncitizens with unsatisfactory immigration status (UIS)," the office said in a statement.

The office explained that California’s Medicaid program gives coverage that goes above Medicaid benefits to illegal aliens.

The Inspector General said that California improperly claimed about $52.7 million in federal medicaid reimbursements.

"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," the IOG stated. "In addition, California did not have any policies and procedures for assessing and periodically reassessing the proxy percentage."

In regard to recommendations for how California could fix the situation, the OIG recommended the state refund the reimbursement to the federal government.

"We acknowledge California’s difficulty in replicating our recalculated proxy percentage and calculated refund amount. By refunding the $52.7 million to the Federal Government using a manual process, the State agency would address our first recommendation," the office said.

House Homeland Security Committee Chairman Mark Green, R-Tenn., said last year that Medicaid emergency spending for illegal immigrants more than doubled from fiscal year 2020 to fiscal year 2021. Green said that Medicaid spending on emergency medical services for illegal immigrants went from roughly $3 billion in fiscal year 2020 to over $7 billion in fiscal year 2021.

Earlier this month, the Biden administration published a new rule that would allow thousands of illegal migrants to get healthcare through ObamaCare.

The new rule, according to a White House statement, removes a prohibition on illegal immigrants protected from deportation under the 2012 Deferred Action for Childhood Arrivals (DACA) program from accessing healthcare through the Affordable Care Act. It could go into effect as soon as Nov. 1.

The administration estimates that 100,000 uninsured illegal immigrants will be able to access taxpayer-funded health insurance under the rule. The immigrants will be able to apply for coverage through Healthcare.org and state-based marketplaces.

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