Dive Brief:
- The state of Pennsylvania is set to repay the federal government $48.8 million over claims that it provided benefits including Medicaid to non-citizens who do not qualify, the Department of Justice (DOJ) has announced.
- The federal government had accused Pennsylvania of providing Medicaid, Temporary Assistance for Needy Families and Supplemental Nutrition Assistance Program to ineligible recipients between 2004 and 2010.
- According to the DOJ, only documented aliens who meet certain criteria for low income and who have lived in the U.S. for at least five years are eligible to receive non-emergency Medicaid and other benefits under the Personal Responsibility Work Opportunity Act.
Dive Insight:
The DOJ said the settlement agreement should not be seen as an admission of liability. However, Pennsylvania is being held accountable, and is slated to pay the settlement fee over the course of five years. Notably, the structure of the agreement indicates that the state is not being charged interest over the five-year period.
The news unfolds as the issue of Medicaid overspending and fraud are ever-more under scrutiny.
"The staff of the civil division in our office has worked closely and diligently with our sister federal agencies, the Pennsylvania Department of Human Services and the Governor's office to make needed corrections to the operation of programs that are vital to low income families," said Peter Smith, US Attorney for the Middle District of Pennsylvania, in a prepared statement. "At the same time, after lengthy negotiations, a fair and reasonable settlement has been achieved in the best interest of Pennsylvania tax payers."