(The Center Square) − The Louisiana Department of Health covered $103 million in ineligible Medicaid costs according to a newly-released audit report.

An audit by the Louisiana Legislative Auditor follows a 2023 report that identified $112 million covered for ineligible individuals by the state's Medicaid program.

In 2023, the Louisiana Legislative Auditor instructed the state health department to begin using data from the Office of Motor Vehicles to determine and identify individuals who are no longer eligible for state benefits. To receive state benefits, the recipient must reside in that state.

In one case, the health department paid more than $29,000 in premiums for a single beneficiary who had not received any services in Louisiana since early 2020 and had been receiving care in Texas since March of that year.

Despite the 2023 warnings and instructions, the department continued to pay managed care organizations on behalf of more than 22,000 adult Medicaid beneficiaries who appeared to have moved out of state.

In many cases, these recipients had either updated their addresses in state systems to non-Louisiana locations or obtained driver’s licenses in other states, both signs they no longer reside in Louisiana and might not qualify for the state’s Medicaid program.

In the 2023 report, the health department disagreed with the auditor's recommendation to use Medicaid's National Provider Identifier, which is a unique identification number for covered health care providers.

In the latest report, the auditor found almost Louisiana 8,000 that only received services from out-of-state providers.

The report also found that LDH paid $92.1 million for nearly 19,250 recipients who received no services at all after red flags — such as out-of-state address changes or license activity — were triggered. Nearly a third of these individuals had already been identified in the Legislative Auditor’s previous report, shared with the state health department in July 2023, but were not removed from the Medicaid rolls.

Part of the problem, the audit notes, lies in the way some individuals are automatically enrolled in Medicaid through other qualifying programs, such as Supplemental Security Income, without additional scrutiny into whether they still live in-state.

The state health department has since taken steps to address the issue. In April 2024, the department signed a data-sharing agreement with the Office of Motor Vehicles to regularly cross-check residency indicators. The first such check was implemented in April 2025 and the health department has since identified roughly 9,000 out-of-state Medicaid enrollees slated for removal.

The agency expects these actions could save $73.8 million annually, including about $10.9 million in state funds.

The state health department agreed with all of the audit’s recommendations, which emphasize the need for tighter oversight and more proactive removal of out-of-state residents from the Medicaid system.