Medicare inappropriately paid $23 million for services recorded as rendered after beneficiaries had died, despite CMS safeguards meant to prevent such payments, according to an HHS Office of Inspector General report.
The OIG identified beneficiaries who died between Jan. 1, 2009, and Dec. 31, 2011, and analyzed Medicare claims and payments from 2011 for those individuals, according to the report. The agency found CMS paid less than one-tenth of a percent of total Medicare expenditures in 2011 ($541.3 billion) to providers, suppliers, Medicare Advantage organizations and prescription drug plan sponsors on behalf of deceased patients.
Medicare Advantage or Part C — through which beneficiaries can obtain coverage through private plans — accounted for $20 million of those improper payments, according to the report. Medicare Part A hospital insurance had the highest average payment per deceased beneficiary at $8,468.
Part B claims accounted for $592,823 improper payments involving 1,541 deceased beneficiaries. The OIG analyzed Part B separately and found 14 providers and suppliers had more than 500 unpaid Part B claims with service dates after patients' deaths.
The OIG also found 11 percent of the improper payments resulted from missing or incorrect dates of death. Of the 17,403 dead patients associated with inappropriate reimbursements, CMS did not have dates of death for 375 who died before or during 2011, accounting for $2.5 million in improper payments. Additionally, the agency had incorrect dates of death recorded in its enrollment database for 105 people, resulting in $84,500 in improper payments.
Based on those findings, the OIG recommended CMS improve existing safeguards to prevent improper payments in the future, take action on improper payments that have been made and correct inaccurate dates of death. CMS should also monitor paid and unpaid Part B claims with service dates after beneficiaries' deaths and take appropriate action toward providers and suppliers who had high numbers of paid and/or unpaid Part B claims for deceased beneficiaries, according to the OIG.
CMS has agreed with all of the recommendations and has vowed to improve its safeguards to prevent further Medicare payments after death, according to the report.
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