Audit: Medicaid errors result in $1 million loss

SALT LAKE CITY — An audit of Medicaid cases presented to the Utah Legislature Tuesday found that while Medicaid eligibility is well-managed, errors cost the program $1 million last year, with room for another million in savings if efficiencies are put in place.

Auditors reviewed 245 eligibility cases and found that about 5 percent contained errors, ranging from one depriving a family of five eligibility because the family's income had been incorrectly overstated to another that would have allowed two recipients to receive benefits who weren't actually eligible.

The Department of Workforce Services, which manages Medicaid eligibility, is plagued by recipients receiving multiple identification numbers — PIDs — because of inconsistent personal information. The audit recommends that DWS regularly report to the Legislature on the progress of reducing multiple PIDs.

“Prior to the new online application launching in May 2012, most PIDs were created manually with worker intervention. This methodology was error prone,” DWS Executive Director Kristen Cox wrote in a prepared statement. “With the new online application in production, the methodology for searching and identifying existing PIDs has changed.”

The audit, delivered by the Utah legislative auditor general, found that losses because of agency error accounted for nearly $1 million in fiscal year 2011.

The audit also recommends that the Medicaid program provide recipients with a one-time plastic eligibility card to reduce errors and the cost to produce monthly paper cards, which Medicaid recipients are currently issued.

“The department has been working collaboratively with legislators, providers and the Utah Health Information Network to create an electronic plastic eligibility card with 'swipe-card' technology to replace the current Medicaid eligibility benefit paper document,” Legislative Auditor General John Schaff wrote in a prepared statement.

Schaff said Medicaid officials want to make sure that the information provided by the current Medicaid eligibility documents continues to be available to providers with any new plastic eligibility card. The Utah Department of Health is working with programmers to upgrade the current system, he said.

The audit estimates the state could save more than $1 million annually if Utah updated its process to provide recipients with a one-time card.

The health department anticipates switching to an electronic plastic eligibility card next year.

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