Watchdog: Medicaid made $289 million in unallowable payments for deceased enrollees


The following is from Judicial Watch.


A federal audit cited by Judicial Watch found that Medicaid improperly paid at least $289 million to insure individuals who were already deceased.

The findings come nearly a decade after Judicial Watch first reported similar problems. Despite years of warnings, the audit shows the issue has continued on a much larger scale.

Medicaid is a joint federal-state program administered by the Centers for Medicare & Medicaid Services (CMS) with an annual budget of about $900 billion. In many states, governments make fixed monthly payments to managed care organizations to cover enrollees.

According to the audit, those payments often continued even after beneficiaries had died. In many cases, deaths were already recorded in the Social Security Administration’s Death Master File, yet payments were still issued.

The Dept. of Health and Human Services (HHS) Inspector General conducted 18 audits since 2016 and found Medicaid agencies improperly made about $289 million in payments on behalf of deceased enrollees. Investigators reported that capitation payments continued after death in 99 out of 100 sampled cases.

The report also cites similar failures involving incarcerated individuals, who lose Medicaid eligibility once imprisoned. In one example, Illinois spent at least $9.5 million on ineligible inmates between 2020 and 2023 after failing to terminate managed care enrollment.

Judicial Watch notes that improper payments are a long-standing issue across the federal government. The Government Accountability Office (GAO) estimated Medicaid made $31.1 billion in improper payments in fiscal year 2024, roughly five percent of the program’s total spending.

For more information, read the full article here.


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