HHS outlines Medicaid scale, costs and potential savings levers; committee questions oversight and evaluation

Pat Trainor, Donna Auckland and Sarah Acre (Division of Medical Services) presented a department briefing focused on Medicaid — the largest portion of the Department of Health and Human Services budget — and discussed administrative structure, federal matching dollars, program integrity and options the state could use to control long-term costs.

"We're going to focus on Medicaid today," Pat Trainor said at the start of the presentation, noting the program's central role in the HHS budget. Donna Auckland, HHS chief financial officer, told the task force: "Every week our Medicaid claims are between $25 and $30,000,000" and that the program pays about $120,000,000 per month through the state's MMIS claims system. Auckland explained that the department houses multiple funding streams and that about 68% of HHS’s budget is federal entitlement spending.

Sarah Acre, executive director of the Division of Medical Services, framed Medicaid as an open-ended federal-state entitlement program and summarized key facts and challenges: North Dakota reported roughly…