February 09,2016

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Aaron Fobes, Julia Lawless (202)224-4515

Hatch, Upton & Pitts Request HHS Watchdog Confirm Medicaid Has Stopped Paying for Dead Beneficiaries & Doctors

House and Senate leaders: In May 2015, Nonpartisan GAO discovered Medicaid programs in four states were paying nearly $10 million for 200 deceased individuals

WASHINGTON, DC – House Energy and Commerce Committee Chairman Fred Upton (R-MI), Energy and Commerce Committee Health Subcommittee Chairman Joseph Pitts (R-PA), and Senate Finance Committee Chairman Orrin Hatch (R-UT) today requested the Health and Human Services Inspector General review the degree to which Medicaid is currently paying for deceased beneficiaries or paying deceased providers/suppliers.

The leaders are checking to see if previously identified vulnerabilities have been sufficiently addressed. They highlight a May 2015 nonpartisan Government Accountability Office report which found, using FY2011 claims data from four states, that approximately 200 deceased individuals received Medicaid benefits totaling at least $9.6 million.

“As Congress considers future improvements to the Medicaid program, we believe additional analysis related to the program’s vulnerabilities for paying for deceased individuals would provide useful data that could help inform our efforts,” wrote Hatch, Upton and Pitts. “Therefore, we request that your office produce an analysis of the adequacy of Medicaid eligibility controls to verify ‘life status’ to ensure that deceased beneficiaries are removed from the Medicaid program and the extent to which Medicaid has made payments on behalf of deceased beneficiaries.”

CMS estimates that federal and state outlays on Medicaid will reach $569 billion this year while the program is estimated to cover 85 million people during that timeframe.

Click here to read the full letter online.