A shocking revelation: $207 million paid to the deceased by Medicaid.
Imagine discovering that a significant sum of money, over $200 million to be precise, was mistakenly paid out by Medicaid to individuals who had already passed away. This eye-opening report from the Department of Health and Human Services' watchdog has sparked a conversation about the need for reform.
But here's where it gets controversial: a new law, the One Big Beautiful Bill, proposed by Republicans, aims to address this issue by requiring state audits of Medicaid beneficiary lists. The Office of Inspector General believes this provision could reduce improper payments in the future.
Aner Sanchez, a deputy regional inspector general, has been studying this issue for a decade and emphasizes that it's not isolated to one state. The problem is persistent and widespread.
The watchdog's report, released on Tuesday, revealed that over $207.5 million in managed care payments were made on behalf of deceased enrollees between July 2021 and July 2022. To recover these incorrect payments, the office recommends sharing a critical database, the Full Death Master File, with state governments. This database contains over 142 million records dating back to 1899.
However, access to this file has been restricted due to privacy laws designed to prevent identity theft and fraud. The recently signed tax and spending bill aims to change this by mandating that Medicaid agencies conduct quarterly audits of their provider and beneficiary lists against the Full Death Master File, starting in 2027.
This report is the first nationwide analysis of improper Medicaid payments. Since 2016, the HHS inspector general has conducted 18 audits of state programs, identifying approximately $289 million in improper payments made on behalf of deceased enrollees.
And this is the part most people miss: the government has already had some success in preventing these improper payments. In January, the Treasury Department reported recovering over $31 million in federal payments that were mistakenly sent to dead individuals. This was achieved through a pilot program that granted the Treasury temporary access to the Full Death Master File.
However, the Social Security Administration (SSA) has been making unusual updates to the file, adding and removing records, which complicates its use. For example, the Trump administration classified thousands of living immigrants as dead and canceled their Social Security numbers, an action that raises concerns about the potential misuse of this critical database.
So, what do you think? Is this new law a step in the right direction to prevent improper payments, or does it raise more concerns about privacy and potential misuse? We'd love to hear your thoughts in the comments below!
