Health Law Blog

Medicare Payments for Zombies: OIG reveals that Medicare Advantage payments sometimes outlive beneficiaries

Just in time for Halloween, in a Medicare audit, the Office of the Inspector General of the Department of Health and Human Services has found that $23 million in Medicare expenditures in 2011 were paid inappropriately after the beneficiary had died.  The vast majority of these overpayments, 86 percent, flowed from Medicare Part C, also known as Medicare Advantage, a program that allows private insurers to offer managed care plans for Medicare beneficiaries.  The average payment for a deceased Part C beneficiary was $1,682.

In the scheme of total Medicare expenditures, these overpayments accounted for only a tiny fraction—less than one-tenth of one percent, according to OIG.  Nonetheless, OIG recommended that CMS take actions that would more closely monitor claims made on behalf of beneficiaries after their dates of death, and to ensure that dates of death are properly documented.

The OIG’s press release in this matter may be viewed here: http://oig.hhs.gov/oei/reports/oei-04-12-00130.pdf

 

Caitlin Monjeau contributed this post.

Tagged with: HHS, Medicare, Medicare Advantage, OIG,

Categories: Medicare,

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