Seema Verma, Centers for Medicare & Medicaid Services Administrator, issued a warning to Medicaid plan sponsors on Thursday, warning the agency would begin unscheduled targeted financial audits.
The warning came at the 2018 Medicaid Managed Care Summit during a speech Verma delivered in which she vowed to bring more transparency to the Medicaid program and “ensuring that states put up their fair share of state matching funds.”
“Transparency must also extend to our health plan partners,” Verma said during remarks at the 2018 Medicaid Managed Care Summit.
“This room understands well that nearly all newly eligible individuals in Medicaid are served through managed care organizations,” she said. “I’m putting you on notice now: CMS will begin targeted audits to ensure that provider claims for actual health care spending matches what the health plans are reporting financially.”
“I have seen firsthand the value that you bring to your partnership with states, and the resources that you can often bring to bear to serve the needs of our enrollees on the front lines,” she said.
CMS is moving forward with Medicaid work requirements despite a court ruling that struck down the agency’s approval of the waiver requested by Kentucky. She said the agency has finalized a work requirements demonstration waiver that it plans to launch in the near term.
Verma cited Arthur Brooks, a conservative writer, as she argued that the work requirements were not intended to “just kick people off Medicaid” but “put beneficiaries in control with the right incentives to live healthier independent lives.”
“I have heard the criticisms and felt the resistance, but I reject the premise, and here is why: It is not compassionate to trap people on government programs or create greater dependency on public assistance as we expand programs like Medicaid,” she said. “True compassion is giving people the tools necessary for self-sufficiency. VTN
