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Medicare Part C Payments for Service Dates After Individuals' Dates of Death

Centers for Medicare & Medicaid Services pays Medicare Advantage organizations for Part C benefits prospectively. A prior OIG review of deceased beneficiaries (OEI-04-12-00130) determined that Medicare improperly made $23 million in payments in 2011, of which $20 million was directly related to Medicare Part C payments that were made that year after beneficiaries' deaths. Federal regulations require that Medicare Advantage organizations disenroll a beneficiary from its Medicare Advantage plan on the death of the individual, which is effective the first day of the calendar month following the month of death. We will determine whether prospective payments made after a beneficiaries' date of death were in accordance with Medicare requirements.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
October 2017 Centers for Medicare & Medicaid Services Medicare Part C Payments for Service Dates After Individuals' Dates of Death Office of Audit Services W-00-17-35772 2018

Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201