Medicare paid health care bills for thousands of illegal immigrants and prison inmates at a cost of tens of millions of dollars, according to a new report by federal watchdogs.
The Center for Medicare and Medicaid services (CMS) paid more than $125 million to providers for treatment of 11,619 prison inmates and 2,575 individuals who were in the country illegally from 2009 through 2011, according to a pair of reports released Thursday by the inspector general of the Department of Health and Human Services.
The federal government is generally prohibited from providing Medicare services to incarcerated individuals or aliens who are unlawfully present in the country under the Social Security Act.
But CMS’s screening methods were not able to detect and recoup payments that violated the Act, the IG found.
"When CMS’s data systems did not indicate until after a claim had been processed that a beneficiary was unlawfully present, CMS’s controls were not adequate to detect and recoup the improper payment," both reports state.
According to the report, information on patients who were incarcerated or living in the country illegally was not readily available to CMS administrators.
A response from CMS in each report said the agency plans on implementing corrective measures in April that will allow it to recoup improper payments. A CMS spokesperson did not respond to additional inquiries.
CMS launched a $77 million computer system designed to prevent fraud in 2011. It had detected just one suspicious expenditure by the end of that year.
Reports suggest the system saved Medicare about $115 million in 2012, a small fraction of the estimated $60 billion Medicare fraud costs American taxpayers each year.