Illegal U.S. residents and inmates are the latest wave of fraudulent Medicare beneficiaries. According to two new reports from the HHS inspector general, from 2009 to 2011 the government paid out more than $120 million in Medicare services to illegal aliens and prison inmates, despite federal laws that makes them ineligible.
The new HHS reports claim it’s a timing issue. By the time Medicare is alerted that someone receiving Medicare benefits is incarcerated or undocumented, the payment is already out the door. According to the report, Medicare’s databases aren’t up to date, exacerbating the improper payment problem. Adding insult to the situation, the Medicare program lacks the capability to get the money back.
The Medicare fraud, waste and abuse news comes just as President Obama told the Congressional Hispanic Caucus that immigration reform would be one of his top priorities. However, he made no mention of how he would address problems the Medicare and healthcare reform problems in the immigrant community.
Upwards of 3,000 illegal immigrants made $91.6 million in claims over the three year period studied in the report. In the same period, 135,000 or more Medicare beneficiaries were incarcerated. About 11,600 inmates submitted claims totaling $33.6 million.
The Office of the Inspector General said that retrieving the money is not feasible, claiming that “[CMS] is committed to recovering overpayments … but it must take into account the cost benefit of recoupment activities, including potential appeal costs and the cost of manually reopening these claims.”
CMS responded to the reports by saying that it would agree to identify improper payments and find ways to try to get the money back in the future. There was no pledge by the agency to recover the money already improperly paid.