We estimated that Illinois did not recover unallowable MCO payments made on behalf of deceased beneficiaries during our audit period, totaling at least $4.6 million ($3.2 million Federal share). We confirmed that 80 of the 94 beneficiaries associated with the 100 capitation payments in our stratified random sample were deceased. Illinois did not recover any of the 84 sampled capitation payments made on behalf of the 80 deceased beneficiaries, totaling $74,319 ($45,032 Federal share). Illinois did not always process Medicaid beneficiaries’ death information in the Medicaid Management Information System. Although Illinois’ eligibility systems interfaced with Federal data exchanges that identify dates of death, Illinois did not enter the dates of death in the MMIS for the majority of our sampled beneficiaries.
Read the Full Summary https://go.usa.gov/xVkbU
Read the Report https://go.usa.gov/xVkbE