State auditor presses for Medicaid information

Judge to decide whether eligibility details can be released
November 9, 2021

State Auditor Kathy McGuiness took on the Department of Health and Human Services Nov. 2 in her months-long attempt to audit Delaware’s Medicaid program.

“We have been doing performance audits for decades,” McGuiness said during a hearing in Superior Court in opposition to DHSS’s attempt to avoid a Medicaid audit. “By limiting information, it hinders the auditor’s ability to do the job.”

In May, McGuiness began seeking information from DHSS to determine the eligibility of people who are receiving Medicaid. DHSS has pushed back, saying the auditor has no right to personal identifiable information, and it went to court to quash the auditor’s request.

McGuiness appealed the motion to quash, and both sides were heard by Superior Court Judge Jan Jurden.

Deputy Attorney General Annie Cordo said McGuiness is seeking to do an audit that is beyond the realm of her duties, even though McGuiness said previous auditors have conducted performance audits.

“Just because something happened once and one state administrator permitted it to happen does not necessarily mean it falls legally within the authority of what the auditor is permitted to do,” Cordo said. “We need to look at what is in the Delaware Code, which is a post audit of financial transactions, not a performance audit of how the program is in fact run, looking for efficiencies and weaknesses.”

McGuiness said her office is not seeking the entire Medicaid database, but income information would be needed to determine the eligibility of Medicaid recipients.

In a June 30 audit conducted by independent auditor CliftonLarsonAllen, the audit found DHSS’s Medicaid program did not consistently follow procedures to determine and monitor provider eligibility. The audit also found the program is unable to support provider eligibility, which may result in un-allowed costs.

Jurden will decide whether the state auditor can proceed with a performance audit with access to Medicaid information.

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