Healthcare Business News

Audit unearths posthumous payments

By Joe Carlson
Posted: September 23, 2010 - 5:45 pm ET

The CMS probably paid more than $8 million between 2006 and 2007 for healthcare services rendered after the patients' deaths, a federal audit (PDF) has found.

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Auditors with the HHS inspector general’s office found that 69,081 deceased beneficiaries had Medicare claims paid after the dates of death listed in CMS records in those years. An in-depth review of 150 of the cases found that all 96 of the Medicare Part A claims had either been recovered or not paid during the regular postpayment review process.

However, 54 dead beneficiaries had Medicare Part B claims for durable medical equipment or physician services that were dated after the death and never recovered, totaling $15,082. Extrapolating those sample results to the whole program, auditors estimated that in 2006 and 2007 CMS paid $8.2 million in Part B claims for the dead.

A letter from Inspector General Daniel Levinson said a major part of the problem was CMS’ lag time in entering accurate dates of death into its master file of enrollees. The CMS’ recovery audit contractors have been directed to try to recover the post-death overpayments identified among the 69,081 beneficiaries in 2006 and 2007, and the CMS is working to add more current dates of death to its master enrollee file.



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