Auditors Suspect $11M Paid to Deceased Fla. Medicaid Patients

August 15, 2005

According to a federal audit, Florida’s Medicaid program may have paid more than $11 million during the past three years to provide medical services for patients who have already died.

State officials told the Gainesville Sun they have a process in place to recover money paid out for claims when the person has died, but the audit, released by the federal Department of Health and Human Services, said Florida didn’t recover all of the money and needs better procedures. The audit scrutinized payments from October 1998 through September 2001 and represents a fraction of 1 percent of the amount the state paid in Medicaid claims.

“The state paid for services claimed to have been performed after death and did not recover some of these overpayments because it did not have adequate payment controls for the prevention, identification, and recovery of payments after a beneficiary’s death,” the audit, by HHS’s Inspector General’s Office said.

In a letter to federal officials, Florida Agency for Health Care Administration Secretary Alan Levine said state Medicaid officials had reviewed the auditors’ draft report and recommendations and would try to recover any overpayments identified.

“In addition we will continue to evaluate and refine our procedures for identifying deceased enrollees in order to prevent overpayments in the future,” Levine wrote.

The Medicaid program, which pays for health care about 2.1 million poor, elderly and catastrophically sick Floridians, is one of the biggest and fastest growing parts of the state budget, at about $12.5 billion last year. It is jointly paid for by the federal government.

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