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Medicaid overexpenditure prior year prompts release of funds; fraud review program expanded
Summary
JBC members described a $223.7 million overexpenditure in Medicaid for FY23-24 that led to a controller 'lock' which the supplemental would release; the Department of Health Care Policy & Financing will also receive funding to expand fraud detection of nonemergency medical transportation and to comply with a DOJ ADA settlement.
Representative Matt Byrd briefed the caucus on the Health Care Policy and Financing (HCPF) supplemental, saying the state had an overexpenditure in Medicaid for fiscal year 2023–24 and must address it in the current budget.
"I just will remind the committee that Medicaid is an entitlement," Byrd said. He reported a FY23–24 overexpenditure of $223,700,000 and described the controller's practice of placing a lock on the subsequent year’s budget so those funds are available to satisfy the prior-year obligation; the supplemental would release that lock.
Byrd also summarized forecast-driven adjustments in medical services premiums, behavioral health, public school health services, Health First Colorado (Medicaid) and CHIP-related items. He said the JBC recommends reallocating unspent American Rescue Plan Act funds in home- and community-based services to boost permitted provider rates and that three technical corrections in the original appropriation yield a net $2.6 million general fund decrease.
On oversight and compliance, Byrd said the supplemental includes $2.4 million in total funds tied to a Department of Justice settlement requiring better compliance with the Americans with Disabilities Act. He further explained the nonemergency medical transportation fraud-detection program that was funded in an emergency supplemental after providers were found to be defrauding the state; HCPF will receive funding to expand and systematize that claims review work.
No vote was taken in caucus; Byrd indicated the HCPF supplemental will be one department bill on second reading.
