Audit: Florida Medicaid paid insurance companies for dead people

Florida’s Medicaid Program has come under criticism repeatedly in recent years for its failure to provide for the care of disabled and poor children in the state.

But it appears if you are dead, the state is willing to pay — especially if that money is landing in the pockets of insurance companies.

Florida is shifting all Medicaid recipients into managed care plans. First up: Nursing home and long-term-care recipients.
When Florida shifted all Medicaid recipients into managed care plans, it ended up paying HMOs $26 million for enrollees who had died.

A federal audit released Tuesday reported that over a five-year period the state’s Medicaid program overpaid HMS $26 million in monthly premiums for enrollees who had passed to the great beyond.

Florida Health News reports it appears monthly Medicaid premiums were paid for several thousands of Floridians who had died.

Medicaid is funded by the state and federal government — and the federal government wants its money back.

Officials with the Department of Health and Human Services said the Florida’s Agency for Health Care Administration needs to pay back $15 million in money lost through operational costs.

AHCA says it has already corrected the problem, recouping almost $24 million of the $26 million in overpayments — a 98 percent success rate.

The five-year period covers a time when Florida Medicaid was changing from a traditional fee-based model to a statewide managed care for all Medicaid participants. The state agency paid HMOs about $1.3 billion from July 1, 2009 through Nov. 5, 2014, the report found.

If you want to read more on the audit, click the Florida Health News Story here.

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