Review of Medicare Payments Made on Behalf of Deported Beneficiaries

EXECUTIVE SUMMARY:

This final report, based on a review requested by the Senate Finance Committee, points out that the Medicare program is vulnerable to improper payments for services rendered to deported beneficiaries. We identified 1,072 Medicare beneficiaries who have been deported. Of these, we determined that 49 had improper payments totaling $836,711 made on their behalf during 1998 and 1999. These improper payments occurred because the Centers for Medicare & Medicaid Services (CMS) did not utilize deportation information in its main database of Medicare enrollment data for processing payments to fee-for-service or managed care providers. In addition to financial adjustments, we are recommending that CMS utilize the deportation information already in its possession to preclude such improper payments. Officials of CMS generally concurred with our recommendations.