Oregon official sounds alarm over Medicaid eligibility

SALEM – Some 86,000 people who are receiving Medicaid benefits in Oregon may be ineligible, costing $37 million per month, the secretary of state said Wednesday.

In an “audit alert,” Dennis Richardson said Wednesday they have not undergone federally required annual benefit eligibility determinations, and represent 8 percent of the state’s entire Medicaid population.

Rep. Dan Rayfield, a Democrat from Corvallis, said Medicaid enrollment data should be cleaned up and eligibility issues fixed. But Rayfield also said “political ploys aimed at grabbing headlines before full information is available” are unhelpful.

Richardson said his audit alerts highlight urgent concerns. Before the Republican was elected in November to the state’s second-highest office, he said in an interview with The Associated Press that being chief auditor of the state would be his most important task. He said some other misspending by the state in big-ticket items had not been audited.

“To make good on my promise to increase transparency and accountability, I am instituting Audit Alerts,” Richardson said in a statement Wednesday. “These alerts will highlight concerns that are too urgent to be delayed until an audit’s completion.”

The Oregon Health Authority, which administers Medicaid in the state, said all recipients have been deemed eligible at some point in time. In a statement, the health authority said it is finishing by May 31 an analysis to determine how many Oregonians still need to go through the redetermination process to ensure they remain eligible for Medicaid benefits.

“It is important to understand that just because a redetermination is not complete, does not indicate that they are ineligible for Medicaid,” the health authority said.

Richardson said his auditors recently discovered that for the past three years, the Oregon Health Authority has spent what may total hundreds of millions of state and federal dollars providing benefits for ineligible recipients. At an average monthly cost of $430 per person, coverage for the 86,000 people costs about $37 million per month.

The Senate Republican Office in the Democrat-dominated Legislature called the situation a “Medicaid fiasco.” Senate Republican Leader Ted Ferrioli, of John Day, called for a bipartisan inquiry.

Medicaid is a program created by the federal government, and administered by the state, to provide payment for medical services for low-income citizens.

The secretary of state’s office recommend the Oregon Health Authority work with the federal regulatory authorities to ensure federal Medicaid funding is not jeopardized while OHA resolves these issues, and that the Legislature require the health authority to report on progress by Sept. 30.