MADISON – Today, the co-chairs of the Joint Legislative Audit Committee announced the release of a statutorily required audit of the BadgerCare Plus Basic Plan by the nonpartisan Legislative Audit Bureau (LAB). Conducted between July and December 2010, the comprehensive evaluation of the BadgerCare Plus Basic Plan was required under 2009 Wisconsin Act 219, which created the program.

 

The purpose of establishing the BadgerCare Plus Basic Plan was to provide temporary, unsubsidized health insurance for childless adults who were on the waiting list for the BadgerCare Plus Core Plan, a Medical Assistance program that imposed enrollment caps in October 2009 due to limited funding. At some point during the six-month period reviewed by LAB, a total of 5,143 individuals were enrolled in the BadgerCare Plus Basic Plan.

 

The LAB identified a number of concerns relating to the sustainability of the BadgerCare Plus Basic Plan. Among them is a deficit of $140,300 as of December 2010 resulting from insufficient monthly premiums paid by enrollees to cover program expenditures. This deficit would have been larger if not for a $1.1 million federal grant appropriated by the State Health Access program.

 

Additionally, the Department of Health Services (DHS) did not begin verifying the eligibility of enrollees each month until December 2010. However, some eligibility criteria, including Wisconsin residency, have not been verified. LAB also found that individuals who were not enrolled in the plan received services, and enrollees received services that are not covered under the program. Altogether, LAB identified 107 inappropriately paid claims for services that totaled $14,600. DHS also identified several enrollees as potentially ineligible for the program because of their income levels and access to private insurance.

 

“We need to take a very close look at the sustainability of this program,” said State Senator Rob Cowles (R-Green Bay).

 

“In addition to the deficit identified by the Legislative Audit Bureau, my biggest concern is the lack of accountability in this program,” said Representative Samantha Kerkman (R-Randall). “Why did it take DHS until December 2010 to begin verifying the eligibility of those enrolled in BadgerCare Plus Basic? Will those found to be ineligible for this program be penalized?”

 

For additional information about the BadgerCare Plus Basic Plan audit or to obtain a copy of it, please visit the Legislative Audit Bureau’s Web site at http://legis.wisconsin.gov/lab/ or call 608-266-2818.