OLYMPIA – Washington state’s Medicaid program made nearly $1 billion in questionable payments last year, and may have to refund millions of dollars for improperly paying illegal immigrants’ medical bills, a state audit says.
The sweeping review by state Auditor Brian Sonntag also questioned the state Medicaid agency’s investigation of some abuse claims and its controls on identity fraud and prescription drugs, including steroids.
Officials with the state Department of Social and Health Services disputed some findings but said they would work with Sonntag to iron out conflicting rules that govern health care programs.
“We share a common goal of ensuring the proper use of public funds,” said Robin Arnold-Williams, the department director.
A yearly probe of Medicaid spending is required under federal law because the federal government splits the program’s costs with the states.
The 155-page audit released Thursday covers the state budget year that ended in June 2005. Washington’s Medicaid program spent more than $6.2 billion in that period, Sonntag said.
Auditors identified almost 30 problem areas for the program. The nearly $1 billion in questioned spending includes more than $83 million in payments for thousands of illegal immigrants’ medical expenses.
Half of that money came from the federal government, which allows its share of Medicaid to be spent on undocumented immigrants only in emergencies.
The state was paying providers for nonemergency care, including treatments for ingrown toenails, dental care and acne, auditors said.
“This is causing the nation’s taxpayers to subsidize Washington state’s noncompliance,” the audit said.
That total includes as much as $32 million in federal money spent on care for pregnant undocumented immigrants, despite an order to limit that care to childbirth. The state may have to refund that money to the federal government, the audit said.
Auditors from the federal inspector general are now performing their own review of the state’s Medicaid spending on undocumented immigrants, officials said.
The DSHS, which oversees Medicaid, said it has since improved policies for tracking improper spending. The federal audit should clear up any other policy misunderstandings, the department wrote.
State auditors also reviewed the department’s policy for sex-change surgeries, some breast surgeries, and other potentially elective procedures. State Medicaid officials said they had paid more than $110,000 for two gender-reassignment surgeries since 2000, and about $12,600 for corrective surgery after a sex-change operation performed in another country.
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