|Financial Audit Division Report 18-09||Released July 12, 2018|
During calendar year 2017, the Minnesota Department of Human Services (DHS) paid approximately $6.68 billion for health care coverage for people who were age 65 or older and people who were blind or had a disability and were enrolled in Medical Assistance (MA). DHS oversees MA eligibility processes, while county agencies review applications and determine the eligibility of individuals for MA programs. Statutory requirements and DHS eligibility processes for these particular populations are complicated and require reporting and verification of enrollee income and assets, such as bank accounts, real estate, and vehicles.
As required by Minnesota Statutes 2017, 3.972, subd. 2a(b), the Office of the Legislative Auditor conducted this audit to determine whether persons enrolled in a Medical Assistance program were eligible to receive benefits under the program. The audit scope included eligibility determinations made during calendar year 2017.
We concluded that DHS and county agencies Generally Complied with eligibility requirements for the Medical Assistance population included in our audit scope. Among enrollees who were age 65 or older and enrollees who were blind or had a disability, DHS and county agencies determined eligibility accurately in most of the samples we tested. However, for a small percentage of enrollees, DHS eligibility policies were not followed, or the enrollees did not meet eligibility requirements.
Legal Compliance - Generally Complied
Finding 1. The Department of Human Services did not ensure that some county agencies properly verified reported assets when determining the eligibility of some Medical Assistance enrollees.
Finding 2. Using the Department of Public Safety’s electronic vehicle registration system, we identified vehicles that were not reported by some Medical Assistance enrollees to county agencies; these vehicles did not affect eligibility.