Tax data to be included for Medicaid eligibility verification starting in May

Tax data to be included for Medicaid eligibility verification starting in May
Source: PEXELS

BATON ROUGE, LA (WAFB) - The Louisiana Department of Health (LDH) intends to strengthen Medicaid eligibility verification by receiving tax information from recipients. The additional information allows LDH to consider “critical” eligibility factors, such as household income.

LDH says it will begin receiving the tax information in May of 2019

“A person who earns too much to qualify should not get Medicaid coverage,” LDH officials wrote in a handout discussed with lawmakers. “Situations like this — even if they are the exception — must be prevented and dealt with.”

In April, a new computer system initiated quarterly, rather than annual, wage eligibility checks. More than 30k people were deemed ineligible as a result.

LDH boasted additional figures supporting its efforts to tackle improper Medicaid payments. The list includes:

  • Quadrupling the number of State staff dedicated to the detection and prevention of fraud and abuse in the managed care program.
  • Doubling the number of staff dedicated to fraud, waste, and abuse investigations in the managed care program and requiring managed care organizations (MCO) to collectively share fraud and abuse tips and complaints. This led to a 300 percent increase in tips & complaints shared by organizations and a 250 percent increase in MCO fraud cases
  • Notifying the Attorney General’s Medicaid Provider Fraud Unit of suspected cases of fraud or abuse, in addition to referral of confirmed cases, which led to 173 notices of suspected fraud and a 94 percent increase in referrals of confirmed fraud to the Attorney General’s Medicaid Provider Fraud Unit.

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