Warren, Wyden, Sanders, Warnock Probe Medicaid Contractors on Faulty Eligibility and Enrollment Systems
“Thousands of eligible Medicaid beneficiaries are erroneously denied coverage each year due to eligibility systems plagued by errors.”
Washington, D.C. - U.S. Senator Elizabeth Warren (D-Mass.) joined Senator Ron Wyden (D-Ore.), Ranking Member of the Senate Finance Committee; Bernie Sanders (I-Vt.), Ranking Member of the Senate Committee on Health, Education, Labor and Pensions; and Raphael Warnock (D-Ga.) in launching an investigation into four of the largest contractors that build state Medicaid eligibility, enrollment, and information management systems across the country, as reports continue to emerge that these systems are plagued with errors, leading to faulty coverage denial for Medicaid beneficiaries. The stakes are even higher now that the Republican budget bill mandates the creation of even more enrollment checks and verification systems for every state.
“We believe it is [your company’s] responsibility to build systems that allow people to access the health care benefits they need to be healthy and be able to participate in the workforce, rather than to prioritize their bottom line,” wrote the senators.
The letter, sent to Conduent, Deloitte, General Dynamics Information Technology (GDIT), and Gainwell Technologies, asks the companies to detail their contracted payment structures, the documentation individuals are required to provide for Medicaid eligibility through their systems, any penalties that states may levy for wrongful terminations, their ability to update systems following the identification of errors, and more data and information related to the companies’ performance in administering these systems across the country.
The letter comes as the Republican budget bill creates new red tape requirements that every state must meet before the end of next year to verify that enrollees engage in certain so-called “community engagement” activities, like employment, community service, a job search or training program, or education for 80 hours per month. Previous attempts by states to implement similar so-called “work requirement” programs have resulted in significant coverage losses, low enrollment, and no impact on employment rates, at a significant cost to taxpayers.
“The addition of paperwork hurdles, layered onto problematic eligibility systems, will cause Americans to lose Medicaid coverage to this bureaucratic maze,” the senators added.
The senators requested more information from the companies by October 31, 2025.
Earlier this year, Warren and Wyden began investigating another contractor, Maximus, for similar practices.
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