Medicare Paid $9.3 Million to Nearly 500 Illegal Immigrants

Article author: 
Ritika Gupta
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Article date: 
Wednesday, October 5, 2016
Article category: 
National Issues
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Responding to claims of nearly 500 illegal immigrants, the Centers for Medicare and Medicaid Services paid $9.3 million in their benefit in 2013 and 2014, The Washington Free Beacon reported.

According to an audit from the agency's inspector general, Medicare paid out over 14,500 claims.

"Medicare benefits are generally allowable when rendered to a beneficiary whom the Social Security Administration has determined to be a U.S. citizen or U.S. national," the audit said.

"Medicare does not pay for services rendered to beneficiaries who are unlawfully present on the date of service."

While the agency is advised to be cautious against improper payments, it is also required to ensure that payments for Medicare services are not remitted to individuals who are not legally present in the United States....

"When CMS's data systems did not indicate until after a claim had been processed that a beneficiary was unlawfully present, CMS had policies and procedures to detect and recoup payment for Medicare services, but it did not follow them," the audit said.

In 2013 and 2014, the audit established that the agency paid out 14,530 claims amounting to $9,267,392 in Medicare payments for 481 illegal immigrants.

"When Medicare has paid health care providers for services rendered to beneficiaries who are subsequently determined to have been unlawfully present at the time of services, Medicare requirements state that those improper payments should be recouped," the audit states.

Promising to recoup payments, Andy Slavitt, an administrator at the Centers for Medicare and Medicaid Services said, "CMS is committed to making sure that improper payments are not made for health care services provided to unlawfully present beneficiaries."

"CMS will review the overpayments referred by [inspector general] and identify overpayments greater than or equal to $1,000. CMS will attempt to recoup these overpayments," he said.

"At the conclusion of this collection effort, CMS will perform a cost-benefit analysis to determine if CMS should pursue similarly situated overpayments in the future," he added.