government
Md. audit finds Medicaid keeps paying for dead people
NEWS IN BRIEF — Posted Dec. 19, 2011
Maryland's Medicaid agency has not ended payment of Medicaid fees for all enrollees who die outside the state, according to an audit released Dec. 2 by the Maryland Dept. of Legislative Services' Office of Legislative Audits.
Auditors found that the state paid at least $426,403 in Medicaid fees between Jan. 1, 2008, and Aug. 31, 2011, relating to the coverage of 10 people who had died. Most of the improper payments were monthly capitation fees paid to Medicaid managed care organizations.
State auditors found the discrepancies by comparing state Medicaid enrollee records with death records kept by the Social Security Administration. They found 323 possible cases in which Medicaid fees appear to have been paid after a Maryland enrollee died out of state. However, auditors found that only 10 of the first 20 cases they reviewed in detail were actual payment errors.
The Social Security death record database does include a small number of people who are still alive, but that error rate typically is less than one-quarter of 1%, according to the audit. Auditors recommended that state Medicaid officials regularly cross-reference Medicaid enrollee records with the federal database.
The Maryland Dept. of Health and Mental Hygiene plans to begin using the SSA data to verify Medicaid enrollment, said Charles Milligan, the department's deputy secretary for health care financing. The SSA database has fewer errors than it once did, he said.
Maryland's Medicaid program cost $7.7 billion in fiscal year 2011, more than half of which was paid for by the federal government, according to the audit, which is available online (link).
Note: This item originally appeared at http://www.ama-assn.org/amednews/2011/12/19/gvbf1219.htm.
