OIG: Medicare made $34.6M in improper payments on behalf of prisoners

Medicare made $34.6 million in improper payments to incarcerated individuals from Jan. 1, 2013, through Dec. 31, 2014, according to a recent report from HHS' Office of Inspector General.

Medicare generally does not pay for services rendered to incarcerated beneficiaries. However, there is an exception to this rule if state or local law requires incarcerated beneficiaries to repay the costs of medical services they receive.

During 2013 and 2014, the $34.6 million in improper payments were made on behalf of 11,786 beneficiaries who were incarcerated, according to the report.

Based on its findings, the OIG recommended CMS fully comply with Medicare requirements that prohibit payments to incarcerated beneficiaries, review the $34.6 million in improper payments to determine if any portion can be recouped by Medicare contractors and identify improper payments made to incarcerated beneficiaries after the OIG's audit period to ensure Medicare contractors recoup those payments.

In written comments, CMS concurred with most of the OIG's recommendations and said it reinstated its process for identifying and recouping overpayments in September.

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