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New law could fix $207 million Medicaid problem and stop ‘improper’ payments

KANIKA SINGH RATHORE, 24/12/202524/12/2025

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Medicaid Programs improperly raised over $200 million Payment health care providers for those who have already died between 2021 and 2022, according to a new report from the independent watchdog. health department And human services.

But the department’s Office of Inspector General said it hopes a new provision in the Republicans’ One Big Beautiful bill that would require states to audit their Medicaid beneficiary lists could help reduce these improper payments in the future.

These types of improper payments “are not unique to any one state, and this problem is persistent,” Aner Sanchez, assistant regional inspector general in the Office of Audit Services, told The Associated Press. Sanchez has been researching the issue for a decade.

The watchdog report released on Tuesday said more than $207.5 million in managed care payments were made on behalf of deceased enrollees between July 2021 and July 2022.

The office recommends that the federal Government Share more information with state governments to recover erroneous payments – including a Social Security database known as the Full Death Master File, which contains more than 142 million records dating back to 1899.

The huge tax and spending bill signed into law by President Donald Trump this summer expands how the full death master file can be used.

The huge tax and spending bill signed into law by President Donald Trump this summer expands how the full death master file can be used. ,Getty Images for Caring Across G,

Sharing the complete Death Master file data is strictly prohibited due to privacy laws that protect against identity theft and fraud.

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The massive tax and spending bill that was signed Law by the President donald trump This summer it expanded how the full death master file can be used by mandating Medicaid agencies to quarterly audit their provider and beneficiary lists against the file starting in 2027. The intention is to stop payments to dead people and improve accuracy.

Tuesday’s report is the first nationwide look at improper Medicaid payments. Since 2016, the HHS Inspector General has conducted 18 audits on select state programs and identified that Medicaid agencies made approximately $289 million in improperly managed care payments on behalf of deceased enrollees.

The government had some success earlier this year in using the full death master file to prevent improper payments. In January, the Treasury Department reported that it had clawed back more than $31 million in federal payments that improperly went to deceased people as part of a five-month pilot program after Congress gave Treasury temporary access to the file for three years as part of a 2021 appropriations bill.

Meanwhile, the SSA is making unusual updates to the file, adding and deleting records, and complicating its use. For example, in April the Trump administration declared thousands of living immigrants dead and canceled their Social Security numbers in a crackdown on immigrants who had been allowed to stay in the US temporarily under programs started during the Biden administration.

Uk fiximproperlawMedicaidmillionpaymentsproblemstop

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