Our review found that the Centers for Medicare & Medicaid Services (CMS) made approximately $3.61 million of unallowable payments on behalf of deceased Medicare enrollees to prescription drug plan sponsors for coverage periods after the enrollees' months of death. CMS made improper payments for 1,500 of the 2.7 million deceased enrollees (far less than 1 percent of the enrollees who died). As of January 31, 2010, $3.61 million in improper payments remained uncollected. CMS's systems categorized these enrollees as alive or as having different dates of death than those listed in the Social Security Administration's death master file. Although CMS had correctly stopped payments for the vast majority of deceased enrollees, its systems did not always identify and prevent the improper payments. In addition, CMS did not always recover payments made on behalf of deceased enrollees on a timely basis.
We recommended that CMS (1) recoup the $3.61 million in payments for deceased Medicare enrollees, (2) recover improper payments in a timely manner, and (3) implement system enhancements to prevent and detect future improper payments for deceased enrollees. CMS concurred with our recommendations but said that it believed it had recovered the $3.6 million in payments made for deceased Medicare enrollees. Nothing in CMS's comments caused us to change our findings or recommendations. As of January 2010, CMS had not recouped the payments.
Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555 begin_of_the_skype_highlighting 1 888-428-2555 end_of_the_skype_highlighting, Ext. 200.
We recommended that CMS (1) recoup the $3.61 million in payments for deceased Medicare enrollees, (2) recover improper payments in a timely manner, and (3) implement system enhancements to prevent and detect future improper payments for deceased enrollees. CMS concurred with our recommendations but said that it believed it had recovered the $3.6 million in payments made for deceased Medicare enrollees. Nothing in CMS's comments caused us to change our findings or recommendations. As of January 2010, CMS had not recouped the payments.
Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555 begin_of_the_skype_highlighting 1 888-428-2555 end_of_the_skype_highlighting, Ext. 200.
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