Department of Health and Human Services

Office of Inspector General -- AUDIT

"Audit of Medicaid Payments for Deceased Beneficiaries in Florida," (A-04-03-07029)

July 28, 2005


Complete Text of Report is available in PDF format (642 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

Our objective was to identify any Medicaid overpayments resulting from payments to providers for medical services claimed to have been rendered after the month in which a beneficiary died.  We found that Florida made Medicaid payments for medical services claimed to have been rendered after the month of a beneficiary’s death.  Specifically, for a sample of 200 Medicaid payments made on behalf of eligible beneficiaries who died during our audit period, the State made 48 payments after the beneficiaries’ deaths that amounted to $15,765 ($8,811 Federal share).  We recommended that the State:  (1) review our sampling universe to identify and recover, where appropriate, overpayments estimated at $11.6 million ($6.5 million Federal share) made on behalf of deceased beneficiaries and (2) improve its procedures for identifying deceased beneficiaries to prevent overpayments in the future.  In response to our draft report, the State Medicaid agency agreed to implement our recommendations.