• Tyler Brooks

N.C. State Auditor: Over $100 Million in Medicaid Errors

Updated: Apr 24, 2019

As reported by Carolina Journal, a new audit released by North Carolina State Auditor Beth Wood has identified over $100 million in errors made by the state's Medicaid program as well as other deficiencies in certain parts of the North Carolina Department of Health and Human Services.

Carolina Journal reports that auditors "found some claims lacked documentation to show the services were rendered." Moreover, the State Auditor faulted the state for paying "a projected $29.1 million in Medicaid payments for ineligible beneficiaries resulting from incorrect and inadequately documented eligibility determinations."

As to the Medicaid qualification process, the audit recommends that the state Department of Health and Human Services "ensure eligibility determinations are performed accurately and are adequately documented." In particular, the report recommends greater oversight of county departments of social services by the state to ensure "eligibility determinations are accurate and supporting documentation is maintained in the client files." The report also recommends additional training for county social services workers.

As Carolina Journal explains, "overpayments to providers, along with benefits paid to ineligible recipients, reduced the money available to pay for Medicaid recipients' services." Medicaid, of course, is an important financial resource for seniors once they require nursing home care.

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