Wisconsin Medicaid paid for care of dead people

Dept. of Health Services says it will get refunds

A federal audit of Wisconsin’s Medicaid program found that nearly $600,000 was paid to managed care organizations on behalf of patients who already had died.

The finding comes from an audit by the U.S. Office of Inspector General covering the years 2010 through 2015. During that period, $589,478 in erroneous state Medicaid payments were made on behalf of dead people to managed care groups.

The inspector general said the state should recover the faulty payments from the health organizations and refund the federal government its share of the money, which it calculated at $347,822.

The inspector general investigates waste, fraud and abuse in Medicare, Medicaid and other U.S. Department of Health & Human Services programs.

The Wisconsin money involved

1,654 so-called capitation payments, which are monthly fixed payments on behalf of enrolled individuals who are low-income or who have disabilities. Medicaid is jointly administered by states and the federal government.

“Somebody is supposed to be checking if a person is dead or alive,” said state Sen. Jon Erpenbach (D-Middleton), a member of the state Senate’s health and finance committees. “Obviously the process didn’t work.”

During the five-year period of the audit, the state contracted with 31 managed care organizations and made payments of $12.8 billion.

“Whether it’s overpaying on transportation projects, allowing 3,000 sex offenders to go unaccounted for, or spending nearly one million of our tax dollars flying the state plane around Wisconsin, Scott Walker has been downright careless and wasteful with Wisconsin taxpayer dollars,” Britt Cudaback, a spokesperson for Tony Evers, Democratic candidate for governor, said in a email.

The audit faulted the state for not always using a system that contained death information about those receiving Medicaid.

“They could certainly do a better job,” said Don White, a spokesman for the Office of Inspector General.

Julie Lund, a spokeswoman for the Wisconsin Department of Health Services, declined to comment on the audit. She noted that DHS Secretary Linda Seemeyer sent a letter to the inspector general earlier this month.

In the letter, Seemeyer acknowledged the errors and said the department would get the money back from the managed care organizations and refund the federal government.

“The Department intends to pursue multiple avenues to improve the accuracy and timeliness of death determinations to ensure accurate payment for beneficiaries,” Seemeyer wrote.