The Centers for Medicare and Medicaid Services has improperly paid millions of dollars to Medicare Advantage organizations on behalf of illegal immigrants.
In a new report released Friday, the Department of Health and Human Services’ Office of Inspector General (OIG) revealed that for calendar years 2010 through 2012, CMS provided $26.2 million in improper payments to Medicare Advantage organizations for 1,600 “unlawfully present beneficiaries” – or nearly $16,375 per illegal immigrant.
According to the OIG, CMS did not have policies in place to notify the Medicare Advantage organizations about the legality of potential beneficiaries. Without such data, illegal immigrants were able to enroll with Medicare Advantage organizations.
“In contrast to its fee-for-service (FFS) program, CMS did not have policies and procedures to notify the MA organizations of the unlawful-presence information in its data systems. Had CMS provided this information to the MA organizations, they would have been able to prevent enrollment and to disenroll beneficiaries already enrolled,” the report reads. “CMS would then have been able to recoup any improper payments.”
Illegal immigrants are barred from obtaining federal health-care benefits. Last year, the OIG revealed that from 2009 to 2011, Medicare payments to health care providers for services rendered to illegal aliens totaled more than $91.6 million.
In its April report, OIG recommended that CMS recover the $26.2 million in improper payments on behalf of illegal immigrants, adopt policies to notify the organizations about unlawful-presence information, and recoup improper payments made after the audit period.
The OIG report noted that CMS partially agreed with the recommendations – concurring with OIG’s second recommendation, but said it was unable to agree to the specific OIG estimate because it said it could not confirm the amount.