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Recent Publications

Department of HHS OIG

The Office of Inspector General (OIG) is conducting a series of reviews examining Medicare payments made on behalf of individuals who are unlawfully in the United States. It recently reported that Medicare made payments to health care providers for services to such individuals under Parts A and B fee-for services (FFS) program.1 It has now released another report that found $26.2 million in improper payments were made by the Centers for Medicare & Medicaid Services (CMS), under Part C, to Medicare Advantage (MA) organizations for approximately 1,600 unlawfully present beneficiaries.2


1. Medicare Improperly Paid Providers Millions of Dollars for Unlawfully Present Beneficiaries Who Received Services During 2009 Through 2011. A-07- 12-01116. Medicare made improper Part A and B payments of $91.6 million, region7/71301125.pdf.

2. Medicare Improperly Paid Medicare Advantage Organizations Millions of Dollars for Unlawfully Present Beneficiaries for 2010 through 2012. A-07- 01125.

This article was published in the May 15, 2014 edition of Managed Care Outlook. Reprinted with permission.
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