Corporate Compliance

CMS continued Advantage payments after beneficiaries' deaths

Healthcare Auditing Weekly, March 17, 2009

On March 4, the OIG reported CMS made $4.4 million in unallowable payments to Medicare Advantage organizations on behalf of Medicare beneficiaries months after the beneficiaries died.

At the beginning of each month, CMS makes payments to Medicare Advantage organizations for medical services provided to individuals Medicare Advantage plans. CMS made improper payments for 2,657 beneficiaries between January 2003 and April 2007, according to the report

The OIG recommended CMS:
  • Recoup the $4.4 million in payments for deceased Medicare enrollees, based on the information relayed in the OIG report
  • Implement systems enhancements to prevent and detect improper payments in the future
CMS concurred with the OIG’s recommendations.

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