California immigrants are receiving wrongful Medicaid payments, and top Republicans are demanding answers from Governor Gavin Newsom and the federal government.

The Senate Budget Committee's top Republican is requesting information from the Newsom and Biden administrations regarding the repayment of $52 million in "unjustified" Medicaid payments made through "MediCal" to specific immigrants.

On Friday, Sen. Charles Grassley of Iowa will write to California Gov. Gavin Newsom and CMS administrator Chiquita Brooks-LaSure, requesting information on the state's commitment to repay the federal government $52 million for incorrect payments made to "noncitizens with unsatisfactory immigration status."

The DHCS representative acknowledged the findings of an inspector general's report and pledged to repay the feds by June 30.

Grassley claims that Congress is unaware if a remittance occurred or if it did not happen.

Grassley wrote to Newsom that HHS Inspector General Christi Grimm's investigation discovered that the state overstated its reimbursable emergency care percentage by 8.49%, resulting in a false claim of $52,652,698 from October 2018 to June 2019.

"The OIG of HHS advised California to repay the $52.7 million that was incorrectly claimed during the specified time frame and collaborate with CMS to identify any additional incorrectly claimed reimbursements for periods beyond the scope of the OIG audit."

Grassley stated that the recommendation made by the inspector general for California to adjust its algorithm for determining Medicaid disbursements to immigrants was not implemented.

"As of today, the measures remain unimplemented. Each state must take proper care to safeguard the American taxpayer from fraud, waste, and abuse," Grassley wrote.

He requested a list of questions for Newsom to answer by Sept. 5.

"Has California returned any portion of the money it received from the federal Medicaid program? If yes, how much and when? If not, why not?"

"How does California determine its share of reimbursable income?"

Grassley questioned why the California DHCS is using a "manual process" to repay the feds rather than an immediate lump sum, given that California's annual budget is approximately $300 billion.

Federal Medicaid benefits are typically restricted to citizens and qualified noncitizens, as highlighted in the May audit conducted by Grimm. Examples of qualified noncitizens include refugees, asylees, and those who have been lawfully admitted for permanent residence.

During FY 2019, more than $372 million in federal Medicaid reimbursements were made on behalf of noncitizens, as per the audit.

The report attributed, in part, the difference in "improperly claimed" Medicaid reimbursements for a specific noncitizen group to outdated algorithmic metrics used in California.

Grassley stated that the economic conditions under President Biden and Vice President Harris have resulted in households being forced to stretch their dollars in every way possible due to financial difficulties.

Grassley stated that California is using taxpayers' money to provide federal health insurance to ineligible illegal immigrants, despite being ineligible.

"California confirmed months ago that it owed CMS improper reimbursements, which is a slap in the face and we should know what CMS is doing about it."

Grassley pointed out in his letter to Brooks-LaSure that the Social Security Act of 1935 mandates the federal government to reimburse states through her agency for a portion of their Medicaid expenses.

Typically, only emergency services are covered for noncitizens with unsatisfactory immigration status after five years of coverage.

Grassley stated that MediCal, the state's equivalent to Medicaid, utilizes state funds to provide comprehensive coverage for noncitizens with UIS by paying each managed care plan a monthly capitation.

Brooks-LaSure was asked by him if California had repaid their liability and if her agency had initiated any review to prevent such occurrences in the future.

According to HealthCare.gov, illegal immigrants are not eligible for federal coverage and disbursements under the Affordable Care Act.

CMS was contacted by Planet Chronicle Digital for an independent update on the repayment of California's agreed-upon Medicaid remittances.

An official from California's DHCS announced plans to repay the requested amount by June 30 in a statement.

The spokesperson stated that DHCS has collaborated with the federal Centers for Medicare & Medicaid Services to improve the service identification methodology and payment and claiming processes.