(WASHINGTON, D.C.) – Today, Ranking Member of the Senate Homeland Security and Governmental Affairs Committee Tom Coburn, M.D. (R-OK) highlighted two new reports from the Department of Health and Human Services Office of Inspector General that show Medicare paid millions to dead doctors, dead beneficiaries, undocumented workers and illegal aliens.  The reports show Medicare wasted $23 million in care on the deceased in 2011, $25 million on dead doctors between 2009-2011, and $29 million for prescription drugs to more than 4,000 unlawfully present beneficiaries between 2009-2011.  

“Awarding benefits to the deceased is dead wrong,” Dr. Coburn said.  “I am particularly concerned about this latest development because, despite being notified of this problem five years ago, the administration continues to pay dead doctors.  Every individual wrongfully awarded benefits, be it the deceased or undocumented, diverts scarce resources away from those who need it most.  That is why Chairman Carper and I introduced the Improper Payments Agency Cooperation Enhancements Act, which enhances coordination between agencies with anti-fraud and waste mechanisms that will curtail this egregious practice.  Congress should pass this bill without delay. At the same time, the administration must take action to work with all agencies to ensure those who do not qualify for benefits do not receive them.” 

Key findings include: 

Medicare Wrongly Paid $29 Million in Drug Costs for 4,000 People Illegally in U.S.

Under federal law, health care benefits are not allowed to be paid for services provided to unlawfully present beneficiaries.  However, a new report from the Inspector General of the U.S. Department of Health and Human Services finds that the Medicare program wrongly paid drug costs totaling $29 million on behalf of 4,139 unlawfully present individuals.  Medicare program officials have said they will correct the problem, but have not given a timeframe for implementing needed corrective actions, nor have they agreed to recoup monies lost during this year and last year for the same reason. 

Medicare Wrongly Paid $23 Million for Dead Patients in 2011 

Under federal rules, Medicare claims for health care benefits are not supposed to be paid for dead people who were enrolled in Medicare beneficiaries. However, a new report from the Inspector General of the U.S. Department of Health and Human Services finds that the Medicare program wrongly paid $23 million in 2011 for services after a Medicare patient was already dead. These dollars represent a preventable waste of taxpayer dollars and have a harmful effect on an already cash-strapped program cumulative effect year over year. Medicare program officials have said they will correct the problem, but have not given a timeframe for implementing needed corrective actions. Moreover, despite ongoing Congressional oversight and concerns about the program’s integrity, Medicare officials clearly failed to take proactive preventative steps in this area.

Medicare Wrongly Paid $25 Million to Dead Doctors Over 3-Year Period 

Under federal rules, Medicare is not supposed to pay the bills of dead doctors. Yet, a 2008 Congressional hearing that Dr. Coburn participated in revealed Medicare was paying millions of taxpayer dollars for dead doctors. Earlier this year, Dr. Coburn asked the Inspector General of the U.S. Department of Health and Human Services, to see if this was still a problem within Medicare. The Inspector General reviewed Medicare claims and found that Medicare had paid $25 million to dead doctors from 2009 to 2011. Given some the lag time in billing, there may be some circumstances where some of those payments may be legitimate. Yet, even the most conservative approach to eliminating potentially valid claims found Medicare paid at least $8.2 million for dead doctors!  Despite that Medicare officials have told this was a problem five years ago, they still have not given a timeframe for implementing corrective actions. 

Reports available here:

Medicare Payments Made on Behalf of Deceased Beneficiaries in 2011

Medicare Improperly Paid Millions of Dollars for Prescription Drugs Provided to Unlawfully Present Beneficiaries During 2009 Through 2011

Supporting Documents:

HHS Letter to Dr. Coburn 

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