Sen. Charles Grassley of Iowa has demanded accountability from both California Gov. Gavin Newsom and Centers for Medicare & Medicaid Services (CMS) administrator Chiquita Brooks-LaSure regarding the repayment of $52 million in Medicaid disbursements made to certain immigrants with “unsatisfactory immigration statuses.” An inspector general’s report found that California over-counted its reimbursements by 8.49 percent, leading to the improper claim of $52,652,698 from October 2018 to June 2019. Grassley is seeking updates on California’s promise to repay this amount to the federal government, as it has not been done to date.
Grassley has sent letters to both Newsom and Brooks-LaSure, asking for details on the repayment of the $52 million in wrongful disbursements and questioning why California has not yet adjusted its algorithm for determining Medicaid disbursements as recommended by the inspector general’s report. He has also questioned California’s use of a manual repayment process rather than an immediate lump sum, given the state’s annual budget of $300 billion. Grassley wants answers from Newsom by September 5 on whether any repayment has been made, the current methodology for reimbursable income quantification, and why the repayment process has not been completed.
The inspector general’s audit found that federal Medicaid benefits are typically limited to citizens and qualified noncitizens, such as refugees, those granted asylum, or lawful permanent residents. The report highlighted an outdated algorithm used by California that led to the improper claim of Medicaid reimbursements for noncitizens. Grassley criticized California for providing federal health insurance to ineligible illegal immigrants while households are struggling financially amid economic conditions created by the Biden administration. He emphasized the need to protect taxpayers from fraud, waste, and abuse.
Grassley questioned Brooks-LaSure on whether California has repaid its liability for the improper Medicaid reimbursements and whether CMS has taken steps to prevent similar issues in the future. He noted that, under the Social Security Act of 1935, the federal government reimburses states for a percentage of their Medicaid costs, but only emergency services are typically covered for noncitizens with unsatisfactory immigration statuses. Illegal immigrants remain ineligible for federal coverage under the Affordable Care Act, according to HealthCare.gov. Grassley is seeking accountability from CMS on California’s repayment of the Medicaid remittances.
California’s Department of Health Care Services (DHCS) has expressed plans to repay the $52 million to the federal government by June 30 and has worked with CMS to develop a more refined service identification methodology with updated payment and claiming processes. Grassley’s investigation aims to ensure that proper care is taken to protect American taxpayers from fraudulent Medicaid disbursements. Grassley’s inquiries highlight the need for transparency and accountability in Medicaid disbursements to ensure that federal funds are used appropriately and efficiently.
