Medicaid Enrollment Using the Express Lane Eligibility Option Did Not Always Meet Federal Requirements 

States generally determined Medicaid eligibility using the Express Lane Eligibility (ELE) option in accordance with Federal requirements. Under the ELE option, a State Medicaid agency can use findings (e.g., income) from eligibility determinations made by a different agency within the State to facilitate enrollment into Medicaid. From our sample of 157 beneficiaries, States correctly determined eligibility for 133 beneficiaries. We found no errors in 6 of the 10 States reviewed; however, 4 States did not determine eligibility for 17 beneficiaries in accordance with Federal requirements. On the basis of our sample, we estimated that 731,365 beneficiaries were eligible, but 86,672 were potentially ineligible. We also estimated that Federal and State Medicaid payments on behalf of eligible beneficiaries totaled $1.5 billion, and Federal and State Medicaid payments made on behalf of potentially ineligible beneficiaries totaled $284.1 million. We attribute the enrollment of potentially ineligible beneficiaries to State-specific eligibility determination errors.