A shocking revelation has come to light, highlighting a major issue with Medicaid payments. Over $207 million was paid to deceased individuals, a staggering amount that could have been avoided. This problem, as an independent watchdog report reveals, is not isolated to one state, but rather a persistent issue across the country.
The Department of Health and Human Services' Office of Inspector General has stepped in, aiming to address this concern. They believe a new provision in the One Big Beautiful Bill, requiring state audits of Medicaid beneficiary lists, could be the solution.
"These improper payments are a nationwide concern," says Aner Sanchez, an assistant regional inspector general. Sanchez, with a decade of research on this topic, emphasizes the urgency of the matter.
The watchdog's report, released on Tuesday, delves into the specifics. It reveals that between July 2021 and July 2022, more than $207.5 million in managed care payments were made for deceased enrollees. The federal government is now recommending better information sharing with state governments, including access to the Full Death Master File, a comprehensive database with over 142 million records dating back to 1899.
However, privacy laws have restricted access to this file, making it challenging to prevent such improper payments. The recent tax and spending bill, signed by President Trump, aims to change this by mandating quarterly audits of Medicaid provider and beneficiary lists against the Full Death Master File, starting in 2027.
This report is the first of its kind, providing a nationwide overview of improper Medicaid payments. Since 2016, the HHS inspector general has conducted 18 audits, identifying approximately $289 million in improper payments made on behalf of deceased enrollees.
But there's a glimmer of hope. Earlier this year, the Treasury Department successfully recovered over $31 million in federal payments that had been improperly made to dead people. This was achieved through a five-month pilot program, made possible by temporary access to the Full Death Master File granted by Congress.
However, the SSA has been making unusual updates to the file, adding and removing records, which complicates its use. For example, the Trump administration's move to classify living immigrants as dead and cancel their Social Security numbers, as part of a crackdown on certain immigration programs, has further muddled the situation.
So, while there are steps being taken to address this issue, it's clear that more needs to be done. The question remains: How can we ensure that Medicaid payments are accurate and not going to those who are no longer with us? What are your thoughts on this matter? Feel free to share your opinions and insights in the comments below!
