CMS issues program integrity guidance to state Medicaid agencies

The Centers for Medicare & Medicaid Services last week issued guidance outlining certain assurances that state Medicaid agencies should make “to ensure that program resources are reserved for those who meet eligibility requirements.” CMS said the guidance addresses concerns raised by recent audits that found “some states did not always determine Medicaid eligibility for expansion adults in accordance with federal and state requirements.” States in the process of expanding coverage to low-income adults under the Affordable Care Act “should provide these assurances of compliance with applicable program requirements when submitting the appropriate state plan amendments to CMS,” the agency said.