GAO Report Urges Tighter Medicaid Screening

CMS should develop guidance for screening deceased Medicaid beneficiaries and provide more comprehensive data to screen Medicaid providers, the Government Accountability Office (GAO) said in a report released on Friday.

The GAO’s report cited “thousands of Medicaid beneficiaries and hundreds of providers involved in potential improper or fraudulent payments during fiscal year 2011.” The data were culled from four states -- Arizona, Florida, Michigan and New Jersey -- and represents the most recent period during which reliable data could be found. The report noted:

• Approximately 8,600 beneficiaries had simultaneous payments from two or more of the GAO’s selected states totaling at least $18.3 million.
• The identities of 200 deceased beneficiaries, who received about $9.6 million in Medicaid benefits after their deaths.
• Around 50 providers denied participation in federal healthcare programs, including Medicaid, due to “patient abuse or neglect, fraud, theft, bribery, or tax evasion.”

The report and its ramifications will be discussed Tuesday at a House Subcommittee on Oversight and Investigations hearing.