WASHINGTON, D.C. – The Centers for Medicare & Medicaid Services is cracking down on states’ use of taxpayer dollars allotted to Medicaid to pay for unauthorized treatments for noncitizens.

The federal government allocates billions of dollars each year to states to help pay for Medicaid, healthcare for lower income Americans, one of the federal government’s largest expenditures. States are generally allowed to use Medicaid to cover emergency and lifesaving treatment for illegal immigrants, but CMS said it is cracking down on the practice of states using federal dollars to cover treatments not authorized under Medicaid for noncitizens.

CMS said that states are “pushing the boundaries” of what can be covered under Medicaid, at taxpayer expense.

“Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders,” said CMS Administrator Dr. Mehmet Oz. “States have a duty to uphold the law and protect taxpayer funds. We are putting them on notice – CMS will not allow federal dollars to be diverted to cover those who are not lawfully eligible.”

Democrats have denied the allegation that some states, generally Democrat-led, use Medicaid dollars for illegal immigrants. Republicans insist they use loopholes or don’t check immigration status as a way to circumvent federal rules. They argue that free healthcare of this kind is what helps motivate the influx of illegal immigrants into the U.S.

“Medicaid funds must serve American citizens in need and those legally entitled to benefits,” said CMS Deputy Administrator and Director of the Center for Medicaid & CHIP Services Drew Snyder. “If states cannot or will not comply, CMS will step in.”

CMS sent a letter to the states this week warning them of the ratcheting up on controls and that the federal government could demand back any federal dollars improperly spent on noncitizens.

“To ensure that federal money is not used to pay for or subsidize healthcare for individuals with an unsatisfactory immigration status in a manner contrary to federal law, CMS is ramping up financial oversight activities of state claiming in this area, to the extent consistent with applicable law,” the letter said. “Activities are expected to include focused reviews of Medicaid expenditures reported by states on the quarterly CMS-64 and in-depth financial management reviews.”