A new report released by the internal watchdog agency of the U.S. Department of Health and Human Services (HHS) revealed that during the period from 2021 to 2022, the government paid over $200 million in improper payments to healthcare providers through the Medicaid program for individuals who were actually deceased.
According to the Office of the Inspector General at HHS, the Republican-sponsored “One Big Beautiful Bill” included a new provision requiring states to audit their Medicaid beneficiary lists, which is expected to help reduce such improper payments in the future.
Aner Sanchez, Assistant Regional Inspector General at the HHS Office of Audit Services, stated in an interview with the Associated Press that these improper payments are not limited to just one state and the problem continues to persist.
Sanchez has been researching this issue for the past decade.
The report released by the HHS Office of Inspector General on Tuesday, December 23, stated that from July 2021 to July 2022, the federal government paid over $207.5 million in Medicaid benefits to deceased enrollees. The office recommended sharing more information between the federal government and state governments to recover these erroneous payments, including using a database called the “Full Death Master File,” which contains over 142 million records dating back to 1899.
Due to privacy laws aimed at preventing identity theft and fraud, data sharing from the “Full Death Master File” has been strictly limited.
President Trump signed a large-scale tax and spending bill this summer, expanding the use of the “Full Death Master File” and authorizing institutions operating the Medicaid program to conduct quarterly audits of providers and beneficiaries starting from 2027 to stop payments to deceased individuals and improve data accuracy.
The report released on Tuesday marks the first nationwide review of improper payments in the federal Medicaid program. Since 2016, the HHS Office of Inspector General has conducted 18 audits across various states, identifying that institutions operating the Medicaid program improperly received approximately $289 million in benefits on behalf of deceased individuals.
Earlier this year, the federal government made some progress in preventing improper payments using the “Full Death Master File.” In January, the U.S. Department of the Treasury reported that in a five-month pilot program, they had recovered over $31 million in federal funds improperly paid to deceased individuals. In the 2021 appropriation bill, Congress authorized the Treasury Department to temporarily use the file for three years.
Meanwhile, the Social Security Administration (SSA) has been making some unusual updates to the file itself, including adding and deleting records, making the usage of the file more complex.
(This article references reporting from the Associated Press)