In a dire budget year where the state has little money to spare, an audit released Tuesday raises concerns over how Missouri monitors which health care and child care providers are eligible for federal dollars.
In her review of how Missouri spent $8.4 billion in federal funding during fiscal year 2016, Missouri Auditor Nicole Galloway said the state should do more to ensure tax dollars aren’t going toward ineligible recipients, especially as lawmakers struggle to plug a $500 million budget shortfall.
Problems persist in payments made through a child care subsidy program intended to provide care for more than 60,000 low-income children whose working parents can’t afford the market rate.
Galloway found “significant weaknesses” in how the Department of Social Services has administered more than $135 million in subsidies.
Weaknesses have been found in the past involving federal and state money that was being awarded to illegal day care providers, with little accountability.
In an estimated 5 percent of cases reviewed for the audit, payments were made on behalf of children without a valid need. In 17 percent of cases, payments were made without adequate documentation, and didn’t comply with department policies.
The audit is the first in a series of reviews conducted by the state auditor examining what inappropriate spending has contributed to Missouri’s current budget crisis.
When providers receive funds they aren’t entitled to, that’s less money the state has in the bank for those who are truly vulnerable, Galloway argues.
Other findings released include the failure of the Missouri Department of Social Services to review which doctors and hospitals are eligible to receive reimbursement from the state under Medicaid and the Children’s Health Insurance Program, or CHIP.
According to the audit, there’s a backlog of 28,000 providers that haven’t yet been reviewed to determine whether they should be receiving those payments.
The Department of Mental Health also failed to log daily payments to group homes for disabled Missourians, calling nearly $1 million in payments into question, Galloway found.
Additionally, the audit revealed 39 shuttered pharmacies in Missouri were still authorized to receive Medicaid and CHIP payments.