Medicaid fails to pay $90M to Washington’s health exchange, audit says
OLYMPIA — A state audit has found that Washington’s health exchange has not been fully reimbursed by the state and federal Medicaid program.
The report released Thursday by the state auditor’s office said the exchange, the state marketplace for health-insurance plans, has not been reimbursed for nearly $90 million in Medicaid services provided on behalf of the Health Care Authority from January 2014 through June 2016.
The audit said the exchange used at least $51 million in federal grants, which may need to be repaid. If the exchange had received full reimbursement, it would recover $12 million more for the second half of the current fiscal year, and more than $77 million for 2014 and 2015, the report said.
The head of the exchange said in a response letter that the exchange “is fully committed to establishing an ongoing process and identifies and defines equitable reimbursement for its Medicaid activities.”