Audit: Texas Paid $5.5 Million In Medicaid Payments To Dead People

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Texas Paid $5.5 Million in Medicaid Payments to Dead People

Texas’ Health and Human Services Commission paid out $5,521,704 in Medicaid payments to dead people between 2013 and 2015.  This is according to a 2017 audit from the Department of Health and Human Services Office of Inspector General.

The majority if this money was paid out in “capitation” payments.  This is when the state pays a private contractor (in this case, old folk’s homes and palliative care facilities) for a beneficiary’s medical services, when they are enrolled in a state plan.  This payment is made regardless of whether said beneficiary actually receives medical services—there is little-to-no oversight.

According to the auditor’s report:

The State agency performs monthly reviews of capitation payments and beneficiary eligibility to identify and recover unallowable payments made after a beneficiary’s death. . .

We compared the dates of death noted in the Texas Medicaid eligibility system or the State Bureau of Vital Statistics records to [Social Security Administration]’s dates of death to confirm whether SSA’s dates of death were correct. . .

We determined that 107 of the 174 deceased beneficiaries, or 61 percent, had payments made over one year after their dates of death.

Eventually these payment mistakes add up.  In fact, at the federal level improper payments are at an all-time high, and totaled some $144 billion in 2016.  Reigning-in the government’s incompetence could go a long way to reducing America’s debt.

Peter Tyler and Nicholas Pacifico, from the nonpartisan Project on Government Oversight, shared four recommendations on cutting back government waste in an essay for The Hill:

  1. Complete the EstimatesAll federal agencies should correctly and completely estimate their improper payments. Most importantly, the Department of Defense, whose spending is roughly half the discretionary budget of the federal government and whose estimates the GAO and its own inspector general call “unreliable,” should comply with this basic requirement.
  2. Eliminate Root Causes. Agencies should do a much better job detailing the steps and timelines for not only identifying but also eliminating, the root causes of its improper payments. This is required by current law, but the administration could issue new directives to ensure consistent implementation. 
  3. Share Best PracticesThe administration should quickly establish robust and high-level working groups for sharing proven solutions in order to better detect and prevent improper payments and fraud across all federal agencies. This would include sharing of advanced data analysis techniques.
  4. Stop Fraud. The Fraud Reduction and Data Analytics Act, passed by Congress last year, aims to prevent fraud by requiring agencies to use stronger financial tools and practices. The administration should complete required guidance to federal agencies — which is now overdue. 

Of course, this is all easier said than done.  But time is running out: if we don’t get spending under control, the debt will become unsustainable—an economic disaster will be inevitable.

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