Millions Paid to Ohio Medicaid Contractors On Behalf of …..(Oops!)…Deceased Beneficiaries, Feds Say

Ohio officials mistakenly  made more than $90.5 million payments to contractors for medical services under Medicaid on behalf of  beneficiaries who had died, federal officials say in an investigative report.

That was found in a random sample of 100 so-called capitation payments made to Medicaid Managed Care Service Organizations.  Ohio eventually recovered 37 payments, but did not recover the remaining 63 — which amounted to at least  $51.3 million in unapproved payments, according to the federal Health and Human Services Inspector General’s Office. That amount includes $38 million in federal funds.

“Ohio did not always identify and process Medicaid beneficiaries’ death information. Although Ohio’s eligibility systems regularly interfaced with Federal data exchanges that identify dates of death, county caseworkers did not always receive notification that beneficiaries had died,” the report said.

“We confirmed that all beneficiaries associated with the 100 capitation payments in our stratified random sample were deceased,” it added.

Not that this hasn’t happened before in the U.S.

Since 2016, Florida, Texas and Tennessee have made payments after beneficiaries’ deaths, according to HHS.- Joe Cantlupe, HealthDataBuzz


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