$125 Mil in “Improper” Medicare Payments for Illegals, Prisoners

Lack of timely communication between federal agencies has cost the U.S. government as much as $125 million for medical care that isn’t even supposed to be provided to illegal immigrants and incarcerated criminals.

It’s yet another case of government incompetency that’s like a swift kick in the stomach during a $16 trillion (growing by more than $3 billion daily) national debt crisis. Because the Social Security Administration can’t seem to provide accurate information on time, Medicare, the government insurance for the elderly, makes improper payments for services it shouldn’t even be financing.

During a recent two-year period U.S. taxpayers spent $92 million for the medical care of 2,600 illegal aliens and $34 million to treat 12,000 prisoners, who already get their healthcare needs met by states, according to separate federal audits. The fleecing was first reported a few days ago by a weekly publication that covers the healthcare industry.

The story cites two reports issued this month by the Department of Health and Human Services Office of Inspector General. The first reveals how Medicare, the government program that provides health insurance for people aged 65 and over and those with disabilities who have worked in the U.S., regularly pays for the healthcare costs of ineligible foreigners living in the country illegally.

During a sample probe that spanned from 2009 to 2011, investigators reviewed 133,541 claims on behalf of 2,575 unlawfully present beneficiaries with $91,620,548 in associated Medicare payments. The Centers for Medicare & Medicaid Services (CMS), the agency that runs the program, approved payments because the Social Security Administration didn’t give it verification data relating to unlawful presence in a timely manner, the probe found. When CMS got the information on time, it was able to flag illegal aliens who are not eligible for services.

Each year a chunk of the money paid for the inpatient and outpatient hospital care of illegal aliens. In 2009 the tab for those services was around $31 million, with $25 million in 2010 and nearly $10 million in 2011. The other high expenses were for physician services and skilled nursing facilities. This is only a small sampling so the cost could very well be much higher. The inspector general recommends implementing policies and procedures to recoup the “improper payments” rendered to unlawfully present beneficiaries. Since it’s not their money, the feds currently have no such process.

The second report identifies 135,805 Medicare beneficiaries who had been incarcerated at some point during calendar years 2009 through 2011 and were therefore not eligible for the program. This is because state’s pick up the healthcare costs of jailed populations. Auditors limited the review to 75,639 claims on behalf of 11,619 incarcerated beneficiaries with $33,587,634 in associated Medicare payments, so again, there are probably a lot more. Like in the case of illegal aliens, the feds have no process to recoup the money. That’s because it’s not coming out of their pocket.