GAO: Medicaid eligibility screening for long-term care is inconsistent across states

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Sen. Orrin Hatch (R-UT)
Sen. Orrin Hatch (R-UT)
The extent to which states conduct asset verification checks on those seeking Medicaid coverage for long-term care varies greatly by state, a government report finds.

All 50 states have conducted data matches with the Social Security Administration when verifying a Medicaid applicant's assets, according to a Government Accountability Office report released Monday. But as of 2011, no state had enacted a 2009 law requiring states to implement an electronic verification system, according to the GAO. The degree to which states used other asset verification processes — such as reviewing earned income, unearned income, financial and investment resources — was not consistent across states.

Senators Orrin Hatch (R-UT) and Tom Coburn (R-OK) requested a GAO investigation to ensure that only qualified individuals receive Medicaid benefits for long-term care. According to the report, Medicaid paid for almost half of the nation's $263 billion long-term care expenditures in 2010. States typically conduct asset verification investigations to prevent beneficiaries from deliberately impoverishing themselves to qualify for Medicaid, prior to applying for coverage.

“Given the complexities involved, it may be reasonable for states to adhere to a risk-based approach and focus their eligibility determination efforts on applicants who appear to be more likely to have assets or to have transferred assets that would make them ineligible,” the report states.

Click here for the full report.

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