Stefanik asks for review of Medicaid eligibility

WASHINGTON, D.C. | House Republican Leadership Chairwoman Elise Stefanik sent a letter to state Medicaid contractors involved in Asset Verification Systems (AVS) to ensure assistance reaches those genuinely in need rather than scenarios involving affluent individuals exploiting resources intended for the truly vulnerable. The letter requested a thorough review in light of recent media reports of state Medicaid programs' widespread failure in verifying enrollee eligibility. Stefanik wrote, "I write today with deep concern regarding recent media reports of state Medicaid programs' widespread failure in verifying enrollee eligibility. In light of this, I am requesting a thorough review to ensure compliance with mandated Medicaid eligibility redeterminations per the Consolidated Appropriations Act of 2023." Stefanik said, "As a member of Congress committed to fiscal responsibility and the integrity of federal entitlement programs, I am dedicated to ensuring that taxpayer-funded resources effectively support our nation's most vulnerable populations. Critical programs such as Medicaid must be safeguarded against waste, fraud, and abuse to allow funds to directly benefit those truly in need." Stefanik continued, "Your company is an essential partner assisting state and territorial agencies with Medicaid eligibility verification and detecting potential fraudulent applications and recertifications. As I conduct a thorough review to ensure compliance with mandated Medicaid eligibility redeterminations per the Consolidated Appropriations Act of 2023, your cooperation and insights are invaluable." Stefanik added, "Frequently I have observed scenarios where individuals adhere strictly to the letter of regulations while disregarding their intent. It is vital that assistance reaches those genuinely in need rather than scenarios involving affluent individuals exploiting resources intended for the truly vulnerable." Stefanik said, "Additionally, I seek your input regarding actions by CMS or its contractors that may have disregarded Congressional directives particularly concerning CMS's guidance issued on October 17, 2022. This guidance instructs states not to recover the costs of services from beneficiaries found guilty of Medicaid fraud contrary to explicit Congressional mandates, severely undermining program integrity and accountability." Stefanik concluded, "Thank you for your attention and cooperation. I look forward to your comprehensive response and our continued collaboration to uphold the integrity and effectiveness of federal entitlement programs." Read the full letter here.

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Stefanik asks for review of Medicaid eligibility

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