DHS seeks independent audit of past Medicaid rates

The Department of Human Services is initiating an independent audit of the state’s Medicaid rates between 2003 and 2011.  DHS Commissioner Lucinda Jesson outlined the plan in a letter Monday to legislative leaders

“This independent analysis will allow an outside independent expert to address, once and for all, whether the state’s payments to those contractors were higher than the amounts allowable under state and federal law,” Jesson wrote. “The results of this analysis will also inform the Medicaid contracting reforms undertaken by our administration since 2011.”

The audit comes after months of scrutiny about Minnesota’s methodology for seeking federal Medicaid dollars. Congressional investigators, along with the federal Centers for Medicare and Medicaid Services, have been looking into whether the state improperly utilized federal dollars to subsidize the state’s General Assistance Medical Care program, which was eliminated by then-Gov. Tim Pawlenty in 2010.

The request for proposal was drawn up with input from Legislative Auditor James Nobles, who has been tracking the issue. Proposals are due on August 13; the audit is supposed to be completed by the end of 2012.

Minnesota’s Medicaid program provides health coverage to roughly 600,000 low-income individuals. The state and federal governments split the tab for the $8-billion-per-year program. Minnesota contracts primarily with four nonprofit health plans to administer the program. Last year legislation requiring annual independent audits of the health plans was enacted, but it doesn’t take effect until 2014.