Medicaid paid over $200 million to dead people in 2021 and 2022, federal watchdog says | Fortune

"But the department's Office of Inspector General said it expects a new provision in Republicans' One Big Beautiful Bill requiring states to audit their Medicaid beneficiary lists may help reduce these improper payments in the future. These kinds of improper payments are "not unique to one state, and the issue continues to be persistent," Aner Sanchez, assistant regional inspector general in the Office of Audit Services told The Associated Press. Sanchez has been researching this issue for a decade."

"The watchdog report released Tuesday said more than $207.5 million in managed care payments were made on behalf of deceased enrollees between July 2021 to July 2022. The office recommends that the federal government share more information with state governments to recover the incorrect payments - including a Social Security database known as the Full Death Master File, which contains more than 142 million records going back to 1899."

"Sharing the Full Death Master File data has been tightly restricted due to privacy laws which protect against identity theft and fraud. The massive tax and spending bill that was signed into law by President Donald Trump this summer expands how the Full Death Master File can be used by mandating Medicaid agencies to quarterly audit their provider and beneficiary lists against the file, beginning in 2027. The intent is to stop payments to dead people and improve accuracy."

The Office of Inspector General found Medicaid programs made more than $207.5 million in managed-care payments for deceased enrollees between July 2021 and July 2022. The issue has persisted across multiple states, with improper payments totaling about $289 million identified in selected state audits since 2016. The OIG recommends that federal data, including the Social Security Full Death Master File, be shared with states to recover incorrect payments. Privacy laws have tightly restricted access to the file because of identity-theft and fraud concerns. A recent tax and spending law expands permissible uses of the file and mandates quarterly audits of Medicaid provider and beneficiary lists against it beginning in 2027 to reduce future improper payments.

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