Corporate Compliance

OIG: CMS must strengthen citizenship verification controls

Compliance Monitor, August 10, 2005

States should do more to verify Medicaid recipients are actually United States citizens, according to the the U.S. Department of Health and Human Services' Office of Inspector General's Office (OIG)

The OIG has completed an investigation that found the Center for Medicare & Medicaid Services (CMS) should do more to strengthen individual state programs that allow would-be beneficiaries to self-declare U.S. citizenship.

In recent years, CMS has encouraged self-declaration in an effort to simplify and accelerate the Medicaid application process. While the policy to allow applicants to self-declare can result in rapid enrollment, it can also result in inaccurate eligibility determinations for applicants who provide false statements, according to the OIG report.

Forty-seven states allow self-declaration of U.S. citizenship for Medicaid eligibility. Of these, 27 states do not verify the accuracy of any U.S. citizenship statements as part of their post-eligibility quality control activities, said the CMS statement.

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