Maryland might not have properly vetted some Medicaid enrollees

Maryland may have allowed residents who did not qualify for Medicaid into the government health program for the poor by failing to consider all of their income, according to a routine audit of the quasi-governmental agency that oversees the Maryland health exchange.

The Maryland Health Benefit Exchange was created under the Affordable Care Act, known as Obamacare, to run an online insurance portal where people could buy insurance if they did not get coverage at work. In Maryland, residents also sign up for Medicaid through the exchange.


Close to 1.3 million Marylanders — about 20 percent of the population — are enrolled in Medicaid, which was expanded as part of Obamacare.

During the audit, spanning fiscal 2015 through fiscal 2017, auditors checked a small number of cases and found that more than a third of the time the exchange considered only state-collected income information and not data from federal sources.


Federal sources are far more comprehensive, possibly allowing people who earn too much to enter or remain in the Medicaid program.

The report also found that the agency did not properly limit who had access to the system and could override eligibility determinations.

The auditors did not determine how many people, if any, received benefits to which they were not entitled.

Michele Eberle, the executive director of the Maryland Health Benefit Exchange, did not dispute the bulk of the findings in a written response to auditors and said the agency would retool its procedures to consider all income sources. She said deep access to the system would be limited to so-called SuperUsers whose job is to address eligibility snafus.

Auditors also found a half dozen other contracting and security issues at the exchange as part of the financial review, some of which were related to the botched launch of the exchange in 2014 and the scramble to fix it. The site crashed on the first day and required a complete technical overhaul. It has run smoothly ever since.

Eberle said systems are all being improved to address the issues, such as not clearing certain information technology contracting with the exchange board, an issue first reported by The Baltimore Sun in 2015; potentially limiting bidding by not allowing sufficient time for proposals; and not properly securing data on formerly used servers.