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State Auditor flags unimplemented Medicaid and CHIP audit recommendations; committee urged to follow up
Summary
Office of the State Auditor told the Joint Health Committee that most agencies implemented audit recommendations but Health Care Policy and Financing still had eight open recommendations — four classified as material weaknesses affecting Medicaid and CHIP eligibility documentation.
The Colorado Office of the State Auditor updated the Joint Health Committee on agency responses to audit recommendations and highlighted outstanding issues at the Department of Health Care Policy and Financing (HCPF).
Auditor Marissa Edwards, a deputy state auditor, told the committee the office publishes an annual SMART Act report tracking audit recommendations that remain unimplemented by agencies. Edwards said the Department of Human Services and Connect for Health Colorado had implemented all recommendations in the five‑year window covered by the report, while “the Department of Public Health and Environment has only one recommendation that it still needs to implement.”
The auditor’s presentation focused on HCPF, which the office reported still had eight recommendations to implement. Monica Power, an audit manager, said four of those eight recommendations are classified as high priority and described them as material weaknesses stemming from the department’s eligibility processes for Medicaid and the Children’s Health Insurance Program (CHIP). Power said the deficiencies related to HCPF’s documentation of eligibility, detection of duplicate Social Security numbers and policies to monitor and address those discrepancies. The recommendations originated in statewide financial audits issued between 2017 and 2021.
Power told the committee that HCPF had delayed implementing some items because the federal COVID‑19 public health emergency required states to maintain enrollment for beneficiaries through May 2023; eligibility work resumed only more recently. The auditor said HCPF’s updated implementation timetable (received as of June) indicates plans to finish the remaining work by late 2024 and early 2025 and urged legislators to question the department when it appears before the committee.
Committee members asked whether failure to implement the recommendations could put federal funding at risk. Power said noncompliance with federal Medicaid and CHIP requirements “could” lead the federal government to recover funds or withhold future payments. Edwards said questions about the status of federal corrective actions and any potential clawbacks are best answered by HCPF, which must engage in federal corrective processes.
Nut graf: The auditor’s update placed the auditor’s highest emphasis on eligibility weaknesses at HCPF that affect federal program compliance; the committee was advised to press the department for current implementation dates when it testifies.
The audit team recommended follow‑up with HCPF and provided the committee with the longer implementation report and agency‑level appendices. Committee members were given the auditor’s summary table showing 110 recommendations still outstanding across state agencies as of June (from more than 1,400 total recommendations made in audits during the period). The auditor said agencies overall have done a “very good job” implementing recommendations but urged scrutiny where material weaknesses remain.
Ending: The auditor closed by offering to provide individual audit reports and contacting agencies that will appear at later hearings so legislators can pursue timely follow up on the open high‑priority items.
