The Centers for Medicare and Medicaid Services has implemented only three of 11 recommendations that the Government Accountability Office made to help address program integrity challenges related to Medicaid.
GAO said Tuesday CMS developedÂ an approach toÂ verify ifÂ an individual isÂ qualifiedÂ to enroll into into the joint federal-state healthcare programÂ but the government watchdog notedÂ gaps remain in measures to confirm eligibility.
Auditors found CMS has yet to ensure that the federal government appropriately matchesÂ Medicaid expenditures for enrollees, especially for individuals that gained eligibility throughÂ the expansion of theÂ Patient Protection and Affordable Care Act.
GAO added the agencyÂ also gave additional guidance to states onÂ the oversight of Medicaid managed care and current resgulations direct allÂ managed care providers to enroll with the state Medicaid agency in an effort to boost oversight of such providers.
A GAO study based on two states and 16 health plans identified challenges in the screening of providers for eligibility.
CMS implemented policies and procedures to prevent duplicate Medicaid and subsidized coverage but the agency has yet to develop a plan to assess whetherÂ those procedures sufficiently mitigate and detect duplicate coverage, according to GAO.