By Christopher Weaver, Anna Wilde Mathews and Tom McGinty | Graphics by Andrew Mollica
Health insurers got double-paid by the Medicaid system for the coverage of hundreds of thousands of patients across the country, costing taxpayers billions of dollars in extra payments.
The insurers, which are paid by state and federal governments to cover low-income Medicaid recipients, collected at least $4.3 billion over three years for patients who were enrolled—and paid for—in other states, a Wall Street Journal analysis of Medicaid data found.
The patients were signed up for Medicaid in two states at once, in many cases following a move from one to the other. Most were getting all their healthcare services through one insurer in one state, even though Medicaid was paying insurers in both states to cover them.
Private insurers oversee Medicaid benefits for more than 70% of the about 72 million low-income and disabled people in the program. The companies get paid each month for each person they cover. They aren’t supposed to get paid if a patient leaves for another state.
Medicaid and Medicare together cost taxpayers more than $1.8 trillion a year. A Journal investigation last year examined ways in which private insurers have increased costs in Medicare, the separate program for seniors and disabled people. Mehmet Oz, President Trump’s choice to lead the Centers for Medicare and Medicaid Services, has pledged to rein in excessive payments to insurers.
The biggest Medicaid insurer, Centene, received $620 million in duplicative payments between 2019 and 2021, the three years analyzed by the Journal. Elevance Health collected $346 million, followed by UnitedHealth Group, at $298 million, the analysis showed. Those companies, the three largest Medicaid insurers, together received more than $200 billion in Medicaid premiums last year.
Disclaimer
The information contained in South Florida Reporter is for general information purposes only.
The South Florida Reporter assumes no responsibility for errors or omissions in the contents of the Service.
In no event shall the South Florida Reporter be liable for any special, direct, indirect, consequential, or incidental damages or any damages whatsoever, whether in an action of contract, negligence or other tort, arising out of or in connection with the use of the Service or the contents of the Service. The Company reserves the right to make additions, deletions, or modifications to the contents of the Service at any time without prior notice.
The Company does not warrant that the Service is free of viruses or other harmful components
