Systemic and Operational Challenges Hinder Efforts to Ensure HIV Care for Medicaid Enrollees, OEI (2024)

This report by the Office of the Inspector General was conducted by interviewing select state Medicaid agencies and comprehensive, risk-based Medicaid managed care plans to explore challenges that contribute to gaps in HIV care and potential actions that could improve their ability to ensure that all enrollees with HIV receive needed care.

The report finds that CMS has opportunities to further support State and Plan efforts to ensure that Medicaid enrollees with HIV receive needed care and makes recommendations that will improve health outcomes and prevent new HIV transmissions.