Comer & Oversight Republicans Press CMS on Medicaid Redeterminations to Reduce Improper Payments

WASHINGTON—House Committee on Oversight and Accountability Chairman James Comer (R-Ky.) and several Oversight Committee Republican lawmakers are calling on Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure to provide documents and communications related to its handling of Medicaid redeterminations after the unwinding of pandemic-era Medicaid continuous enrollment provisions.

“The Committee on Oversight and Accountability is conducting oversight of the cessation of Medicaid continuous eligibility on March 31, 2023. Since President Johnson created Medicaid in 1965 to help low-income and disabled Americans, it has grown to account for approximately $800 billion in annual federal and state expenditures and covers more than one quarter of Americans. Medicaid consistently has a high rate of improper payments; most recently, in FY 2022, Medicaid improper payments totaled $80.57 billion, a significant increase over $57.36 billion in improper payments made in FY 2019. We request documents and information related to Centers for Medicare and Medicaid Services (CMS) efforts to ensure that states will accurately and efficiently complete Medicaid redeterminations to reduce improper payments,” wrote the lawmakers.

The Families First Coronavirus Response Act of 2020 expanded Medicaid and required states to provide continuous eligibility for enrollees through the end of the month unless an individual asks to be disenrolled or ceases to be a state resident. Because of this continuous eligibility provision, Medicaid enrollment grew by 20 million Americans between February 2020 and October 2022. As of April 1, 2023, states will resume reviewing Medicaid enrollees’ eligibility and end coverage for those who are no longer eligible, a process known as Medicaid redetermination.  

“Because states paused most Medicaid terminations and eligibility redeterminations in 2020, state Medicaid agencies will have to undertake a massive review of the eligibility of approximately 91.3 million Americans currently enrolled in the program. Many states will undertake this review while facing labor shortages, which may contribute to delays in redeterminations and risk continued improper payments.” the lawmakers continued. “It is imperative that CMS and state Medicaid agencies take steps to complete Medicaid redeterminations quickly and accurately to reduce improper payments.”

The letter to CMS Administration Chiquita Brooks-LaSure can be found here.