CMS is ramping up federal oversight to prevent states from misusing federal Medicaid funds to care for undocumented immigrants.
Federal Medicaid funds generally only cover emergency care for “noncitizens with unsatisfactory immigration status” who meet other eligibility criteria, but some states have expanded benefits beyond what’s allowed, shifting the cost to taxpayers, according to CMS.
“Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders,” CMS Administrator Mehmet Oz, MD, said in a May 27 news release. “States have a duty to uphold the law and protect taxpayer funds. We are putting them on notice — CMS will not allow federal dollars to be diverted to cover those who are not lawfully eligible.”
As part of the effort, CMS is tightening financial oversight to detect and prevent improper spending. This includes:
- Focused evaluations of select state Medicaid spending reports (CMS-64 form submissions);
- In-depth reviews of certain states’ financial management systems; and
- Evaluating existing eligibility rules and policies to close loopholes and strengthen enforcement.
CMS is urging states to update their internal controls, eligibility systems and cost policies to ensure compliance, warning that improper spending on noncitizens may result in recoupment of federal funds.
“Medicaid funds must serve American citizens in need and those legally entitled to benefits,” Drew Snyder, CMS Deputy Administrator and Director of Medicaid & Children’s Health Insurance Program Services, said. “If states cannot or will not comply, CMS will step in.”
