Texas Did Not Appropriately Spend Some State Balancing Incentive Payments Program Funds

Texas appropriately spent $272.4 million of the $284.4 million in Balancing Incentive Payments Program (BIPP) funds it received. Of the remaining $12 million, Texas inappropriately spent $6.3 million for medical service rate increases that did not benefit Medicaid recipients and did not spend $5.7 million in BIPP funds before the end of the funding period.

Additionally, Texas did not separately track BIPP funds or follow CMS instructions for extending the funding period.

We recommended that Texas refund $12 million in BIPP funds that did not benefit Medicaid recipients or that were not spent before the end of the funding period. Additionally, we recommended that, for future grant programs, Texas separately track funds to ensure the funds are not used in violation of applicable statutory restrictions or prohibitions, and ensure all grant procedures and requirements are met, such as following instructions for extending funding periods. Texas did not indicate concurrence or nonconcurrence with our recommendations and described corrective actions that it had taken or had planned to take.