Il­le­gal im­mi­grants may lose some Medi­care ben­e­fits

The Washington Times Weekly - - Politics - BY TOM HOW­ELL JR.

Fed­eral health of­fi­cials vowed last week to crack down on il­le­gal im­mi­grants who get Medi­care — sig­nal­ing that one part of the Obama ad­min­is­tra­tion be­lieves it has au­thor­ity to deny tax­payer-funded ben­e­fits go­ing to those in the coun­try with­out au­tho­riza­tion.

The Cen­ters for Medi­care and Med­i­caid Ser­vices said it could save nearly $70 mil­lion from 2015 to 2019 by pre­vent­ing il­le­gal im­mi­grants from tak­ing ad­van­tage of Medi­care’s pre­scrip­tion drug pro­gram or en­rolling in Medi­care Ad­van­tage plans.

“We are propos­ing to es­tab­lish U.S. ci­ti­zen­ship and law­ful pres­ence as an el­i­gi­bil­ity re­quire­ment for en­roll­ment in [Medi­care Ad­van­tage] and Part D plans,” said a pro­posed rule posted late Mon­day.

Sen. Tom Coburn, Congress’ top wastew­atcher, said the agency is mak­ing the right move.

“From here, CMS must show they can im­ple­ment their plans with suc­cess­ful re­sults,” the Ok­la­homa Repub­li­can said. “They also should take the nec­es­sary steps to pre­vent pay­ing tax­payer dol­lars to dead doc­tors, doc­tors with felonies, or dead pa­tients.”

The move raises new ques­tions about the fed­eral gov­ern­ment’s ea­ger­ness to with­hold ben­e­fits from il­le­gal im­mi­grants.

Pres­i­dent Obama and con­gres­sional Democrats agreed not to ex­tend Oba­macare ben­e­fits to il­le­gal im­mi­grants, but the In­ter­nal Rev­enue Ser­vice has re­peat­edly re­sisted calls to stop pay­ing a re­fund­able child tax credit to par­ents who are in the coun­try il­le­gally.

CMS tucked its pro­posal into Medi­care reg­u­la­tions that will be for­mally pub­lished Fri­day. The pro­posal also cracks down on doc­tors and providers who pre­scribe un­nec­es­sary med­i­ca­tions or is­sue fraud­u­lent pre­scrip­tions to bilk Medi­care.

Il­le­gal im­mi­grants gen­er­ally are pro­hib­ited from re­ceiv­ing fed­eral ben­e­fits un­der the 1996 wel­fare re­form law.

But an in­ter­nal Health and Hu­man Ser­vices au­dit last year found that while CMS has poli­cies to pre­vent il­le­gal im­mi­grants from get­ting most Medi­care ben­e­fits, it didn’t pre­vent them from tak­ing part in the pre­scrip­tion drug ben­e­fit, or Medi­care Part D, which was added un­der Pres­i­dent Ge­orge W. Bush and ex­panded by Mr. Obama’s health care law.

The Medi­care agency from 2009 to 2011 paid out nearly $30 mil­lion in drug ben­e­fits to il­le­gal im­mi­grants, the HHS in­spec­tor gen­eral said in Oc­to­ber. In one of its re­ports, the in­spec­tor gen­eral said 4,139 il­le­gal im­mi­grants were able to make 279,056 drug ben­e­fit claims.

CMS of­fi­cials ac­knowl­edged the prob­lem at the time and said they would take steps to fix it, al­though some ques­tion whether the agency has the tools to find peo­ple who are ben­e­fit­ing un­law­fully, given that thou­sands were able to get through the sys­tem in prior years.

“They’ve got a long way to go to do what they plan to do,” said David North, a fel­low at the Center for Im­mi­gra­tion Stud­ies.

Whether or not il­le­gal im­mi­grants should reap tax­payer-funded ben­e­fits is an is­sue that res­onates across the fed­eral gov­ern­ment. In 2011, the in­ter­nal au­di­tor at the IRS found that the agency paid $4.2 bil­lion in tax cred­its the pre­vi­ous year to peo­ple who were not au­tho­rized to work in the United States.

“The pay­ment of fed­eral funds through this tax ben­e­fit ap­pears to pro­vide an ad­di­tional in­cen­tive for aliens to en­ter, re­side, and work in the United States with­out au­tho­riza­tion, which con­tra­dicts fed­eral law and pol­icy to re­move such in­cen­tives,” said the re­port from the Trea­sury in­spec­tor gen­eral for tax ad­min­is­tra­tion.

The IRS in the past has said re­peat­edly that it doesn’t be­lieve the law al­lows it to deny il­le­gal im­mi­grants the tax credit, and it dis­putes that it has the le­gal au­thor­ity to deny claims even when they aren’t backed up by doc­u­ments show­ing that the chil­dren live in the U.S.

“The IRS does not have the le­gal au­thor­ity to deny cred­its dur­ing pro­cess­ing when doc­u­men­ta­tion is not pro­vided,” the agency said in its re­sponse to the in­spec­tor gen­eral.

Mr. North said the Trea­sury has made progress by stemming the is­suance of in­di­vid­ual tax­payer iden­ti­fi­ca­tion num­bers that make it pos­si­ble for il­le­gal im­mi­grants to ap­ply for the credit, but he said ex­ist­ing num­bers are still be­ing used.

The IRS, in a re­cent agency state­ment, said it “up­graded tools to de­ter­mine valid iden­ti­fi­ca­tion sub­mit­ted with ITIN ap­pli­ca­tions” and that it “con­tin­ues to look for ways to pre­vent fraud­u­lent re­fund claims, and has pro­ce­dures in place to eval­u­ate ques­tion­able tax credit claims prior to is­suance of a re­fund.”

Repub­li­cans on Capi­tol Hill re­peat­edly have pro­posed chang­ing the law to force the IRS to stop pay­ing the ad­di­tional child tax credit to il­le­gal im­mi­grants.


“From here, CMS must show they can im­ple­ment their plans with suc­cess­ful re­sults,” said Sen. Tom Coburn, Ok­la­homa Repub­li­can. “They also should take the nec­es­sary steps to pre­vent pay­ing tax­payer dol­lars to dead doc­tors, doc­tors with felonies, or dead pa­tients.”

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