Policy: Entitlements

The reason dead people were paid $23 million by a federal program

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Watchdog,Medicare and Medicaid,Entitlements,Inspectors General,Waste and Fraud,Follow the Money,CMS,HHS,Monica Perez

Just because recipients were in the country illegally, sitting in jail or dead didn't keep the federal government from giving them an estimated $190 million in health care payments, according to a government watchdog.

The Centers for Medicare and Medicaid Services mistakenly paid the money between 2009 and 2011, according to the Department of Health and Human Services' inspector general.

CMS is part of HHS. The payments were for services and supplies, including doctor's visits, surgeries and wheelchairs.

At least $23 million of the payments went to dead people, according to the inspector general.

Much more of the money, however -- nearly $92 million -- went to illegal immigrants that the inspector general diplomatically described as “unlawfully present” persons.

Another $34 million went to service providers for beneficiaries who were in jail even though prisons typically provide for the medical care of their inmates, the inspector general said.

An additional $40 million was spent on prescription drug subsidies for undeserving beneficiaries, according to the inspector general.

Electronic health records -- the government's computerized version of a patient's paper chart containing everything about his or her medical history across all doctors and hospitals -- are extremely vulnerable to fraud, which the Washington Examiner reported in January.

The vulnerabilities of EHRs, plus the lack of reporting information on incarceration or death of beneficiaries, were two of the biggest reasons why CMS made the incorrect payments, according to the inspector general.

In addition, CMS requires that the private insurers who that sponsor Medicare plans take corrective action in response to potential fraud, but 28 percent of them failed to do so, the inspector general said.

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Monica Perez

Special to the Examiner
The Washington Examiner