In brief
Between 2021 and 2022, Medicaid programs issued over $200 million in improper payments for individuals who were already deceased, according to an independent watchdog report. An audit provision in the Republicans' One Big Beautiful Bill aims to enhance accuracy in Medicaid eligibility lists and mitigate such errors in the future. The report advocates for better data sharing between federal and state agencies to recover these incorrect payments.
WASHINGTON (AP) — Medicaid programs made more than $200 million in improper payments to health care providers between 2021 and 2022 for services rendered to individuals who had already passed away, according to a new report from the independent watchdog for the Department of Health and Human Services.
The report from the Office of Inspector General indicates over $207.5 million in managed care payments were made for deceased enrollees from July 2021 to July 2022. This issue is reportedly not isolated to any single state, highlighting a persistent problem across the nation.
Aner Sanchez, deputy regional inspector general in the Office of Audit Services, mentioned that the issue has been under investigation for a decade. The Office of Inspector General believes that recent provisions in the Republicans’ One Big Beautiful Bill that mandate states to audit their Medicaid beneficiary lists may help alleviate such improper payments moving forward.
Currently, sharing data from the Full Death Master File, which includes over 142 million records, is limited due to privacy laws aimed at preventing identity theft and fraud. However, the report suggests improved data sharing could assist states in accurately updating their Medicaid lists.
The significant financial drain from these improper payments prompted calls for better communication between federal and state governments. Last January, the Treasury Department reported recovered more than $31 million in federal payments that were mistakenly disbursed to deceased individuals, demonstrating some success in tackling this ongoing issue.
Looking ahead, starting in 2027, Medicaid agencies will be mandated to conduct quarterly audits against the Full Death Master File to prevent further financial waste and increase accuracy in beneficiary tracking.
This recent report represents the first comprehensive evaluation of improper Medicaid payments, revealing a total of nearly $289 million identified in past audits since 2016.
