Jan 25, 2013 Comments Off Toro520
Medicare payments to health care providers for services rendered to illegal aliens totaled more than $91.6 million from 2009 to 2011, a new report released by the Department of Health and Human Services Office of the Inspector General revealed.
The $91.6 million in claims went toward services for a 2,575 illegal aliens. Centers for Medicare & Medicaid Services (CMS) records, however, identified over 29,100 beneficiaries that were in the country illegally at some point in the timeframe the IOG investigated.
The inspector general’s office limited its audit to those 2,575 to look “at whether CMS had adequate controls to prevent and detect improper payments for Medicare services rendered to unlawfully present individuals.”
Federal regulations prohibit Medicare payments from benefiting people in the country illegally. Legal aliens are permitted to receive Medicare benefits.
The inspector general concluded that when CMS had data about the unlawful presence of a potential beneficiary, CMS’ controls were adequate to prevent payment. In many cases, however, CMS did not have information that a potential beneficiary was in the country illegally until after payment and did not have systems in place to recoup the $91.6 million.
CMS generally agreed with the inspector general’s recommendations, which included: recovering the $91.6 million in improper payments, implementing procedures to recoup future improper payments and identifying and recovering other improper payments made after the audit timeframe and before the implementation of new controls.
The report was released Wednesday, along with an audit of incarcerated beneficiaries who improperly received Medicare reimbursed services from 2009 to 2011 — or 11,619 incarcerated recipients at a cost of more than $33.5 million.