U.S. Sen. Rob Portman (R-OH) was among 13 Republicans on the Senate Finance Committee Republicans expressing concerns with the increase in improper Medicaid payments.
The November 2020 Medicaid Payment Error Rate Measurement (PERM) audit found improper payments totaled over $86.5 billion — over 21 percent — mostly driven by eligibility errors. Portman and his colleagues sent a letter to the Centers for Medicare & Medicaid Services (CMS), calling for enhanced program integrity measures and state-by-state analysis to ensure beneficiaries receive the services to which they are entitled.
“One of the most common eligibility errors often occurs when failing to verify information provided by the applicant, including income. Failure to properly verify that applicants are eligible for the program, especially to this extent, harms the nation’s taxpayers and takes resources away from those who are eligible and who truly need the program,” the senators wrote.
The senators are also worried that the November 2020 improper payment rate estimate of 21.4 percent was unrealistically low as the eligibility reviews excluded one-third of states.
“Congress needs complete and updated information about the improper payment rate in Medicaid as well as the corresponding drivers of this problem. We understand that the essential work on the 2021 CMS improper payment report has concluded, and drafts of the report have been completed. While state and Federal responses to COVID-19 halted some payment and eligibility reviews in 2020, this work is too vital to remain paused when the consequences are so dire,” the senators added.