WASHINGTON (AP) — The Medicaid program made more than $200 million in improper payments to health care providers between 2021 and 2022 for people who died, according to a new report from an independent watchdog at the U.S. Department of Health and Human Services.
But the department’s Office of the Inspector General said it expects a new provision in Republicans’ “Big Beautiful Act” to require states to audit their lists of Medicaid recipients, which could help reduce improper payments in the future.
Aner Sanchez, deputy regional inspector general for the Office of Audit Services, told The Associated Press that such improper payments “are not unique to any one state and the problem continues.” Sanchez has been studying this problem for a decade.
A regulator report released Tuesday said more than $207.5 million in managed care payments were made to deceased enrollees between July 2021 and July 2022. The office recommended that the federal government share more information with states to recover incorrect payments, including a Social Security database called the Complete Death Master File, which contains more than 142 million records dating back to 1899.
Sharing of complete death master file data is severely restricted due to privacy laws to prevent identity theft and fraud.
The massive tax and spending bill signed into law by President Donald Trump this summer expanded the use of the Complete Death Master File, requiring Medicaid agencies to audit their provider and beneficiary lists against the file every quarter starting in 2027. The aim is to stop payments to deceased persons and improve accuracy.
Tuesday’s report is the first nationwide investigation into improper Medicaid payments. Since 2016, the HHS inspector general has conducted 18 audits of some state plans and found that Medicaid improperly paid managed care payments totaling about $289 million on behalf of deceased enrollees.
Earlier this year, the government had some success in preventing improper payments using complete death master files. In January, the Treasury Department reported that it had recovered more than $31 million in federal payments that improperly went to deceased persons as part of a five-month pilot program that Congress gave the Treasury Department temporary access to the document for three years as part of the 2021 appropriations bill.
Meanwhile, the SSA has been making unusual updates to the file itself, adding and deleting records and complicating its use. For example, the Trump administration moved in April to classify thousands of living immigrants as dead and revoke their Social Security numbers in a crackdown on immigrants who were temporarily allowed to live in the U.S. under a program launched during the Biden administration.