Medicare
Paying for Health Care for the Dead
HCFA makes $20 million in payments for
procedures allegedly performed on patients after they died
WASHINGTON
-- Senate Governmental Affairs Committee Chairman Fred Thompson (R-TN)
today expressed concern that "Medicare is paying providers
millions of dollars for services that were allegedly performed after
the patients had died." The findings Senator Thompson refers to
are detailed in two recent reports by the Inspector General (IG) for
the Department of Health and Human Services (HHS).
"Like
other federal programs, Medicare does suffer from difficult, complex
management problems," said Thompson. "But in this case,
Medicare has the ability to easily match claims with death notices –
they just don’t bother to run the match."
Based on a
one percent sample of all Medicare claims, the HHS IG found that the
Health Care Financing Administration (HCFA) paid $20.6 million for
Medicare equipment or services provided to beneficiaries after they
died. In another case, the IG discovered that HCFA was paying HMOs on
behalf of enrollees who have been dead for some time, and continues to
make such payments for some who died as long ago as 1993.
In many
cases, HHS’ own records contained death notices for these
individuals yet, it paid more than $8 million in improper claims
supposedly for them. In other cases, HHS had not yet obtained death
information at the time many of these claims were processed.
HHS agrees
with the IG findings and says it has developed an action plan to deal
with them. "While I’m pleased that HHS recognizes this problem
and is trying to fix it," Thompson said, "it should have
been fixed long ago," said Thompson. "Stopping payments to
providers who claim to be providing services to people who are
deceased isn’t rocket science, especially when your own records show
they’re deceased. These improper payments - many of them the result
of fraud - take health care dollars away from those who need
them."
On
November 5th of last year, Chairman Thompson released a General
Accounting Office Report he requested which identified $19.1 billion
in improper payments in just 14 programs administered by nine federal
agencies. Chairman Thompson has since written to Office of Management
and Budget Director Jack Lew urging OMB to take steps to slash the
improper payments. Last year alone, improper Medicare payments
amounted to $ 13.5 billion, or about 8 percent of the entire Medicare
budget.
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The
above-mentioned HHS IG reports are:
Review of
Payments to Medicare Managed Care Risk Plans for Deceased
Beneficiaries, February 2000
Report
A-07-99-01283
Medicare
Payments for Services after Date of Death, March 2000
Report
OEI-03-99-00200