The Centers for Medicare and Medicaid Services improperly paid $1.5 million in benefits to dead people from 2013 to 2015, according to an audit from the agency’s inspector general.
"Because medically necessary services cannot be provided after a Medicare beneficiary dies, payments for claims with dates of service after the individual’s death are generally considered improper payments," the audit states.
While the agency’s policies and procedures were generally effective in preventing most of the improper payments, the agency did not identify and recoup all of them.
The agency verifies Medicare beneficiary information with the Social Security Administration and the Railroad Retirement Board to ensure that claims from deceased individuals are not processed.
"These policies and procedures generally ensured that [the agency] did not make improper payments when its data systems indicated at the time a claim was processed that the individual had died before the claimed date of service," the audit states. "[The agency], however, did not identify and recoup all improper payments."
According to the audit, the agency processed 1,047 Medicare claims worth $1,480,913 for services performed after the recipient’s date of death.
Andy Slavitt, acting administrator at the Centers for Medicare and Medicaid Services, said that the agency is strongly committed to program integrity efforts.
"CMS has extensive policies and procedures in place to prevent or recoup improper payments for Medicare services ostensibly rendered to deceased beneficiaries," Slavitt said. "CMS collects date of death information from the Social Security Administration and through certain claims."
"CMS has edits in place to prevent improper payment of claims with dates of service after verified beneficiary dates of death," he said. "CMS is strongly committed to program integrity efforts in Medicare and continuously works to prevent improper payments for services ostensibly rendered to deceased beneficiaries."
Published under: Medicare