Illinois spent $4.6 million covering deceased Medicaid managed care beneficiaries from October 2015 through September 2017, the Office of the Inspector General for the U.S. Department of Health & Human Services found.
The state did not recover payments made to private insurers administering Medicaid benefits in Illinois, according to the report released last month. Medicaid managed care is the joint state and federal health insurance system for low-income people.
OIG conducted the audit because reviews of six other states, including California, Ohio and Florida, found insurers received payments after beneficiaries' deaths.
It's recommended that Illinois repay $3.2 million to the federal government, which is the federal share of the total $4.6 million in payments. In addition, OIG suggests the state ensure death dates are added to the integrated information system used for Medicaid claims.
Illinois has accepted the recommendations, according to the report.
The audit covered 11,358 monthly capitation payments—which are a kind of payment arrangement for health care service providers—totaling $5.9 million, made between Oct. 1, 2015, and Sept. 30, 2017. Using a random sample of 100 capitation payments, OIG confirmed Illinois did not recover 84 payments made on behalf of 80 deceased beneficiaries.
A representative for the Illinois Department of Healthcare & Family Services didn't immediately respond to a request for comment.
"Medicaid audit shows Illinois spent $4.6 million on dead people" originally appeared in Crain's Chicago Business.