Medicare Compliance & Reimbursement

Watch out for claims after a patient's date of death.

Signs are pointing toward states cracking down on erroneous claims for deceased Medicaid patients.  

Following liability contractor Health Management Systems and a state auditor's reports on Florida's more than $10 million worth of Medicaid overpayments from calendar years 1998 through 2001, the HHS Office of Inspector General issued its own report on Aug. 12.

The OIG reviewed a sample of 200 Medicaid payments that the state issued during the audit period. The state paid 48 of the Medicaid payments after beneficiaries' deaths, which led to $15,765 in overpayments, the OIG found.

Based on this sample, the OIG estimated that from CY 1998 to 2001, the state made $11.6 million worth of payments for services after the beneficiary died and hasn't collected these overpayments.

Result: The state agreed with the OIG's recommendations to collect these overpayments and institute stricter controls over tracking beneficiaries' death dates to prevent overpayments in the future.
 
Grassley Calls For Quick Action
 
"Shutting down payments for services after death should be a quick, easy fix," says Committee on Finance Chairman Sen. Chuck Grassley (R-IA) in response to the OIG's audit. "Agencies need timely communication with each other on a person's death," he adds, referring to the Social Security Administration, which is responsible for reporting beneficiaries' deaths to federal health care programs. To read the audit, go to http://www.oig.hhs.gov/oas/reports/region4/40307029.pdf.