New York Requires Employed Medicaid Recipients To Enroll in Employer-Sponsored Health Insurance

Gao ID: HRD-84-86 August 10, 1984

As a part of its review of the use of recipient health insurance coverage to avoid Medicaid costs, GAO reported on the New York State practice of requiring working recipients to enroll in available employer-sponsored health insurance plans.

GAO found that, if the insurance programs require employee contributions, the state is using Medicaid funds to make contributions to private health insurance programs for employed Medicaid recipients. Even though this practice appears to have the potential for Medicaid savings, the State's imposition of this additional Medicaid eligibility criteria is not permitted by federal law. Such conditions for eligibility are only permissible if the State requests and is granted a waiver from Medicaid requirements for demonstration project purposes.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Michael Zimmerman Team: General Accounting Office: Human Resources Division Phone: (202) 275-6195


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