What Medicaid data should Revenue Department share with legislative auditor? Auditor wants more

Feb. 26-- Feb. 26--Louisiana Legislative Auditor Daryl Purpera said Tuesday he would challenge an Edwards administration interpretation that state law forbids disclosing how many Medicaid enrollees could be making too much money to qualify for state/federal health insurance.

Purpera said his first step would be to seek an opinion from Attorney General Jeff Landry.

"We need to allow the Louisiana Legislative Auditor's Office to have the data they need to their job," Purpera said.

Last year the Louisiana Department of Revenue provided analysis from 2016 income tax returns that indicated about 83,850 Medicaid enrollees could be making too much money to qualify for the government insurance. A request for similar data for 2017 was not nearly as responsive and yielded so little information that Purpera said he couldn't calculate how many people might be improperly enrolled in the government-paid insurance program for children, the elderly and low income -- approximately one-fourth of the state's residents.

Though the federal government pays the lion's share of the costs under the program, the bit that the state is responsible for is the single largest line item in the budget. Democratic Gov. John Bel Edwards sees as a major achievement his reversal of Republican refusals to expand the requirements and allow Medicaid to cover workers who had made too much money to qualify but too little to buy insurance on the private market.

Purpera's report finding that the state may have signed up about 87,000 unqualified enrollees was widely cited in Washington, D.C. by Republicans seeking to undermine the Medicaid expansion portion of the Affordable Care Act.

"I really think that the information provided earlier really shouldn't have been provided," state Revenue Department Secretary Kimberly Robinson said after appearing before the Task Force on Coordination of Medicaid Fraud Detection & Prevention Initiatives.

The Revenue Department can provide statistical reports, such as how many tax filers claimed a particular income level. But what the Task Force sought was data that could determine which filers had claimed a certain income on tax returns and different income on Medicaid applications. That analysis goes too far under state law La. R.S. 47:1508(B) and opens her to criminal prosecution, Robinson said.

Besides the legal prohibition, Robinson noted that tax returns and Medicaid applications define income differently. The insurance applications set income levels based on how many dependents are in a household, but income tax returns have a far stricter definition of dependents that could change reported income levels. And that's before considering that the working poor often hold hourly or seasonal jobs whose pay fluctuates.

Robinson turned over the Revenue Department findings for 2017 to the Louisiana Department of Health.

Of the 893,527 Medicaid recipients, 326,757 filed 2017 Louisiana Individual Income Tax Returns. Of that number, 241,397 reported adjusted gross income of less than $20,001. Only 11,235 reported making more than $50,001.

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