Health

Delaware Judge Supports Auditor’s Efforts to Subpoena Medicaid Records

A Supreme Court judge on Wednesday denied a Delaware Department of Health and Human Services motion to strike down a subpoena from the state auditor’s office asking for information about Medicaid eligibility.

Judge Craig Karsnitz dismissed the view that Auditor Kathleen McGuinness did not have the authority under Delaware law to audit government agencies such as Medicaid and Medical Assistance. Lawyers for DHSS argued that the auditor’s duties were limited to conducting ex post “post-audits” of financial transactions by government agencies.

“To me, this argument is unnecessarily convoluted, and the language of the Delaware statute is clear,” Karsnitz wrote. “A post-audit is an audit of a transaction or transactions after the fact, and a performance audit is a form of post-audit. That’s exactly what we have.”

A DHSS spokeswoman said the agency is reviewing the decision “and will take appropriate further steps.”

McGuinness’s office did not immediately respond to an email asking for comment.

McGuinness invoked her subpoena power last August after notifying DHSS in May 2021 that her office would be conducting a Medicaid eligibility review between July 1, 2017 and June 30, 2020. records, including a list of all people who received Medicaid support during the three fiscal years. She also requested read-only access to the Delaware Medicaid computer systems for two members of the audit team.

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DHSS Secretary Molly Magarik responded by saying that disclosure of certain information, such as the Medicaid enrollment list, is prohibited by law. DHSS also argued that the proposed review was unauthorized and duplicated reviews conducted by other government agencies with legal authority to investigate Medicaid, a program that serves almost a third of Delaware’s population.

Magarik offered “as a sign of good faith and transparency” to provide much less information, including organizational charts, tutorials, and links to DHSS websites that are already in the public domain.

However, McGuinness refused to back down, saying that DHSS had failed for several years to demonstrate that it was effectively screening Medicaid candidates for eligibility before approving or denying benefits.

McGuinness noted that the 2020 mandatory annual review of federal program management included five re-identifications of DHSS-related issues that were previously noted in the previous year’s review. Three of the five re-findings were for the Division of Medicaid and Medical Assistance, which found “significant deficiencies” in relation to compliance with Medicaid provider eligibility requirements and Medicaid provider health and safety standards. The audit also found a “significant weakness” in relation to compliance with Medicaid client eligibility requirements.

“It’s shameless that these failures continue to happen, especially in a Medicaid program that serves such a vulnerable population,” McGuinness said in a press release last year. “Obviously this issue has been around for years – well before the COVID-19 pandemic, so it’s not a good reason these critical Medicaid reviews aren’t happening.”

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The Medicaid scrutiny controversy began months before McGuinness was indicted last October on charges of theft and intimidation of witnesses, as well as misdemeanors, conflicts of interest and failure to comply with public procurement laws. The allegations involved allegations that McGuinness used favoritism by hiring her daughter as a part-time employee in 2020, misstructured payments for a contract with a company she used as a campaign consultant when she ran for lieutenant governor in 2016 year, and intimidated and harassed employees who questioned her behavior.

McGuinness, who as an auditor is responsible for rooting out government fraud, waste and abuse, was acquitted last month of felony charges but convicted of misdemeanor charges of conflict of interest, official misconduct and contract payment structuring. to avoid compliance with public procurement rules. . The case marked the first time in Delaware history that a sitting elected state official was convicted on criminal charges.

McGuinness, who is up for re-election and faces the top Democratic contender next month, faces a suspended sentence of probation, but no convictions have been formally handed down and no sentencing date has been set. The trial judge is currently reviewing post-trial defense motions seeking an acquittal or, alternatively, a new trial.


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