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Senate hearing examines state auditor recommendations to reduce improper Medicaid concurrent enrollment payments
Summary
Senate Bill 5258 would implement portions of a state auditor report aimed at identifying and recovering Medicaid premiums paid for enrollees concurrently enrolled in multiple states. Sponsors, HCA staff, plans and advocates debated likely savings and risks to vulnerable enrollees.
Senate Bill 5258, introduced by Senator Chris Gildon and heard Jan. 24, would implement several recommendations from the Washington State Auditor’s October 2024 performance audit on concurrent Medicaid enrollments. Committee staff said the audit found more than 131,000 people were concurrently enrolled in Medicaid managed care in Washington and at least one other state during 2019–2022, and that Washington paid an average of about $8.6 million per year on unnecessary premiums for clients residing in seven reviewed states.
Julie Tran, committee staff, summarized the bill’s six main elements: require the Health Care Authority to amend contracts and processes to recover premiums for clients later determined to be residents of another state; require HCA to…
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