Qui Tam

Oops! CMS Paid Millions to Medicare Advantage Plans after Enrollees Died

By Nolan and Auerbach

The Centers for Medicare and Medicaid Services (CMS) paid about $4.4 million to Medicare Advantage plans on behalf of enrollees, after those enrollees had died. CMS made the improper payments for 2,657 deceased enrollees between January 2003 and April 2007, according to the March 2009 report “Review of Medicare Payments to Managed Care Plans on Behalf of Deceased Enrollees.”

In the report, Department of Health and Human Services Inspector General Daniel R. Levinson said that his department had recommended that CMS not only recoup the $4.4 million but also correct these improper payments in the future. CMS replied that it had only been able to recover $3.5 million of the unallowable payments due, primarily, to limited resources. CMS and the Office of Inspector General (OIG) have since worked together on procedures to prevent Medicare payments to the deceased, but OIG continues to recommend that CMS recoup the rest of the $4.4 million.

For the entire report, go to http://www.oig.hhs.gov/oas/reports/region7/70701046.pdf. Or, for more information about Medicare fraud, contact Nolan and Auerbach, PA.

Full post as published by Medicare Fraud 101 on March 11, 2009 (boomark / email).