Colorado Medicaid Disputes Findings in Federal Report

Thousands of Blind or Disabled Children Would be Denied Medicaid Eligibility

August 16, 2016

Media Contact
Marc Williams

Denver, CO - The U.S. Department of Health and Human Services, Office of Inspector General (OIG) has notified the Department of Health Care Policy and Financing (Department) that Colorado and six other states received millions of dollars in unallowable bonus payments from the federal government between 2010 and 2015. The payments were made to the Department under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). Colorado was awarded more than $157 million in CHIPRA bonuses and the OIG is requesting the state repay the federal government more than $38 million. The Centers for Medicare and Medicaid Services (CMS) own words describe the CHIPRA bonus payments as a way to “encourage and assist States in reaching and enrolling more uninsured children who are eligible for Medicaid."

“The Department strongly disagrees with the OIG’s findings as we have dutifully complied with federal law, as well as the spirit of the CHIPRA bonus payment provisions,” said Susan E. Birch, MBA, BSN, RN, executive director. “Both the statute and federal guidance emphasize that states include all children who are blind or disabled and who meet eligibility requirements for Medicaid as of July 2008 – ‘with no exceptions, limits or ‘carve-outs.’’ The Department is investigating its options to further contest these findings.”

With this notice, the OIG effectively disqualifies children who are blind or disabled from the CHIPRA bonus payment program calculations. The Department complied with the federal statutory definition of “qualifying children” buy including children who are blind or disabled in the current enrollment data for the CHIPRA Bonus payments. The OIG notice is contrary to the plain language of CHIPRA.

About the Colorado Department of Health Care Policy and Financing

The Department administers Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus as well as a variety of other programs for low income Coloradans who qualify. For more information about the Department, visit