Glitches prompt Medicaid payments for dead Kentuckians

Glitches prompt Medicaid payments for dead Kentuckians

Systems problems at Kentucky's Health Services Cabinet led the Medicaid administration agency to pay thousands of dollars for services for state residents who were no longer alive, a new audit has found.

Cabinet officials are working to improve the state's Medicaid Management Information System to prevent the problem in the future, Kentucky officials said.

The state's Auditor of Public Accounts cross-referenced 30 million payments totaling more than $3 billion with death records maintained by the Public Health Office of Vital Statistics. The audit staff found more than 7,000 payments last year for 'post-death services to some 300 providers totaling more than $360,000.'

The cabinet issued most of the payments to one provider, Passport Health Plan. The plan, administered by University Health Care Inc. of Louisville, Ky., received payments of $285,150 on behalf of more than 300 deceased former Medicaid participants, according to the auditors.

'These premiums were paid to Passport in some cases up to eight years after the former participants died,' the report said.

Passport is aware of the problems and will work with the state to resolve overpayments, said Jill Bell, Passport's vice president of public affairs.

The Medicaid-only services provider receives precalculated payments from the state that are based on enrollment data the plan receives directly from Kentucky, Bell said.

The auditors said the cabinet should overhaul MMIS so that it will compare active Medicaid participants with state death certificate records monthly and check prior payment histories to identify mistaken payments during the system's six-month reconciliation process.

The cabinet said its IT staff is working on a procedure for mainframe-to-mainframe transfer of data on vital statistics to prevent improper payments. Cabinet officials generated a special report from MMIS to pinpoint incorrect payments to Passport since 2001 and plans to recover the funds, the cabinet said.

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