A lag time in getting accurate information from the Social Security Administration caused Medicare to make as much as $125 million in improper payments for healthcare provided to people who were incarcerated or living illegally in the country, two new reports say.
Acting CMS Administrator Marilyn Tavenner partially disputed the findings, saying it wasn't clear that all $125 million was incorrectly paid and that it might be prohibitively expensive to try to recoup all of the money.
Medicare rules say that generally a state government, not the federal treasury, is responsible for the cost of healthcare provided to “incarcerated individuals,” including people in prison, on home detention or living in halfway houses. Medicare is also not responsible to pay for the care of people whose legal status in the U.S. is revoked.
Two reports released Thursday by investigators at HHS' inspector general's office found that the CMS actually did a good job of making sure Medicare doesn't pay for healthcare in cases when the Social Security Administration gives timely information about prisoners' and illegal residents' status.