Report 2024-29
For this audit, we collaborated with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and the Washington State Auditor’s Office. When governments share expertise, technology, or information, government operations can become more efficient and help protect taxpayer dollars.
Why this audit is important
In 2024, Medicaid served over 1.4 million Oregonians, with spending totaling more than a third of the state’s budget. Concurrent enrollment is a nationwide issue costing U.S. taxpayers billions of dollars annually. The Office of Payment Accuracy and Recovery (OPAR) at the Oregon Department of Human Services helps address concurrent enrollment for OHA.
Concurrent enrollment occurs when a person is enrolled in Medicaid in multiple states at the same time. This means two or more states are paying for the same person to have Medicaid benefits at the same time — a wasteful expenditure of limited tax dollars.
What we found
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We found more needs to be done by the federal government to help states identify Medicaid concurrent enrollment. We estimate Oregon potentially spent $29 million on improper Medicaid benefits for recipients residing in Washington from 2019 to 2022. The federal government relies on individual states to identify concurrent enrollments. States do not have access to federal information that could help identify duplicate benefits.
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States with the largest concurrent enrollment with Oregon were California and Washington at $134 million and $65 million, respectively. Some payments are appropriate as many recipients would have been living in Oregon at the time; however, payments for recipients living outside of Oregon would be improper.
What we recommend
We made four recommendations to OPAR. OPAR agreed with all of our recommendations. The response can be found at the end of the report.
