State Auditor Dave Boliek released findings last week from its audit of the North Carolina Department of Health and Human Services, Division of Health Benefits. The audit revealed that DHHS let Medicaid providers with “license limitations, suspensions, or other credential issues to remain on the Medicaid program.”

The Office of the State Auditor shared further on X “The audit was conducted to determine if DHHS implemented fixes for similar issues found in a 2021 audit. This report found DHHS “failed to fully remedy the issue, leaving North Carolina’s Medicaid system and taxpayers vulnerable to fraudulent and potentially dangerous behavior.”

The report also states “A different physician who was prohibited from prescribing controlled medications following a Drug Enforcement Agency (DEA) raid of that physician’s practices remained active in the system, as did a dentist whose moderate sedation permit was suspended for administering general anesthesia without a license.”

The full report can be found here.

Conservative leaders in the North Carolina House began working to transform the Medicaid system in North Carolina a decade ago, with House Bill 372 (2015) beginning the process of moving Medicaid to a managed care system. Following a standoff with then- Gov. Roy Cooper, the funding for Medicaid transformation finally became law in 2020. This long term, forward thinking approach has emphasized improved efficiency and accountability in the Medicaid system.

The audit of DHHS’ Division of Health Benefits comes on the heels of Gov. Josh Stein vetoing legislation that would give State Auditor Boliek increased independence and efficiency.