Review of Medicaid Payments the State of Georgia Made on Behalf of Individuals After Death

EXECUTIVE SUMMARY:

This final report points out that the Georgia Department of Community Health (DCH) had computerized edits in place to prevent payments to providers who make claims for services to Medicaid recipients after the recipients have died.  However, the edits were not 100 percent effective because DCH could not always obtain a recipient's date of death timely.  For the period March 15, 1998 through March 31, 2000, DCH identified an estimated $534,451 ($284,787, Federal share) of payments for services claimed for recipients after their date of death.  We recommended that DCH continue to work with its new Medicaid Management Information Systems vendor to establish an edit that automatically voids claims for periods after a recipient's date of death.  DCH officials agreed with our recommendation.