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Minnesota state and county agencies "generally complied" with procedures when enrolling elderly, blind or disabled low-income residents in the Medical Assistance program, the legislative auditor said Thursday.

The audit, one of three this year that will examine public health care program eligibility, focused on populations that accounted for $6.7 billion in Medical Assistance spending to provide insurance to 205,000 enrollees in 2017.

The Minnesota Department of Human Services (DHS) operates the Medical Assistance program, or Medicaid as it is called in other states, with eligibility decisions typically made by county workers under state and federal guidance.

As detailed in the 20-page report released Thursday, the auditor's office reviewed eligibility paperwork for 100 people in the program. Of those, it found seven cases that had errors, including four that did not have the required documentation. In the other three cases, county workers made mistakes that resulted in approving people for the program whose assets were above limits.

The auditor's report noted that the small review "does not permit us to reliably estimate the error in the overall population of Medical Assistance enrollees."

The Minnesota Senate Republican Caucus issued a news release Thursday saying that the 7 percent error rate suggests that hundreds of millions of Medical Assistance dollars were spent on those ineligible for benefits.

"The lax enforcement by DHS and the counties is undermining the entire safety net," said Sen. Jim Abeler, R-Anoka, chairman of the Senate Health and Human Services Reform Committee.

In her response to the auditor, Human Services Commissioner Emily Piper noted that only 3 percent were found to be incorrectly approved for the program, a rate that was within federal guidelines.

"To take this audit as an example of waste, fraud or abuse, is a misreading of the auditor's report and fundamentally wrong in its interpretation of the findings," Piper said in reaction to the Republican criticism.

The auditor's office this fall will release evaluations of eligibility for adults without children enrolled in the Medical Assistance program as well as the MinnesotaCare program, which provides insurance for people who make too much for Medical Assistance but still less than double the poverty line.

Glenn Howatt • 612-673-7192