Audit of Medicaid Payments of Deceased Beneficiaries in Florida, A-04 -03-07029

Offlce of Inspector General DEPARTMENT OF HEALTH & HUMAN SERVICES Washington, D.C. 20201 JUL 2 7 2005 TO: Dennis G. Smith Director, Center for Medicaid and State Operations , Mv7 Services FROM: for Audit Services SUBJECT: Audit of Medicaid Payments for Deceased Beneficiaries in Florida (A-04-03-07029) Attached is an advance copy of our final report on Medicaid payments for deceased beneficiaries in Florida. We will issue this report to Florida within 5 business days. Our objective was to identify any Medicaid overpayments resulting from payments to providers for medical services claimed to have been rendered after the month in which a beneficiary died. The State made Medicaid payments for medical services claimed to have been rendered after the month of a beneficiary's death. Specifically, for a sample of 200 Medicaid payments made on behalf of eligible beneficiaries who died during our audit period, the State made 48 payments after the beneficiaries' deaths that amounted to $15,765 ($8,811 Federal share). Based on our sample, we estimated that Medicaid claims paid in Florida for services after death totaled $1 1.6 million ($6.5 million Federal share) during the audit period (October 1, 1998, to September 30,2001). The State paid for services claimed to have been performed after death and did not recover some of these overpayments because it did not have adequate payment controls for the prevention, identification, and recovery of payments after a ...