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Louisiana paid nearly $10 million for health care dead Medicaid beneficiaries
Posted on 8/14/25 at 7:48 pm
Posted on 8/14/25 at 7:48 pm
quote:
A review of how Louisiana keeps its Medicaid rolls up to date found the state paid out benefits for more than 1,000 people over the past six years after they died. Nearly $10 million was paid to managed care organizations over that period, even though no health care services were actually provided.
The Louisiana Legislative Auditor conducted its study as part of Gov. Jeff Landry’s Fiscal Responsibility Program, which he has branded LA DOGE. It looked specifically at how state health officials keep track of when Medicaid beneficiaries die and whether outside data sources could help that process.
When auditors used those additional sources, they found 1,072 beneficiaries who died between February 2019 and March 2025 and approximately $9.6 million spent collectively on their Medicaid coverage. Auditors said the actual spending figure is higher because their calculations only included dental coverage payments – and not health coverage – for the final eight months reviewed.
According to the audit report, the Louisiana Department of Health relies on federal and state data sources to identify dead Medicaid beneficiaries. They include Louisiana Vital Records, the Social Security Administration, the Centers for Medicare and Medicaid Services, the state Department of Children and Family Services and the managed care organizations the state pays to deliver Medicaid offerings.
For its analysis, the Louisiana Legislative Auditor’s staff also used obituaries and identified 511 dead Medicaid beneficiaries the state missed in its reviews. Payouts to managed care organizations for this group totaled $5.22 million over the six-year period, and the median time between the beneficiary’s death and the most recent monthly payout to their managed care provider was more than 20 months.
Auditors found 168 more deceased Medicaid beneficiaries through the Social Security Administration’s Death Master File, a source the state health department has not used. The median time between the beneficiary’s death and the latest payment in this group was almost 800 days, according to the audit.
The Legislative Auditor recommended the Louisiana Department of Health determine whether it should use third-party data sources as part of its eligibility determination process to identify deceased Medicaid beneficiaries. Out of the $9.6 million Louisiana paid for Medicaid services never provided, the audit identified $7.6 million through third-party sources.
LINK
Kudos to the Landry Administration on this.
Posted on 8/14/25 at 7:55 pm to ragincajun03
Wait until they audit how these companies are extending care for made up reasons to keep the patients on the payroll.
Posted on 8/14/25 at 8:03 pm to ragincajun03
This sounds terrible and undoubtedly will include some fraud….however, just because someone dies, that does not mean their final month(s) in a nursing home or hospital/hospice does not have to be paid.
Posted on 8/14/25 at 8:11 pm to Spankum
This post was edited on 8/22/25 at 8:10 pm
Posted on 8/14/25 at 8:22 pm to ragincajun03
This sounds like a lag time between death and the cut off of premium payments, and doesn’t seem to suggest fraud.
Anything they can do to get the info quicker is good. I hope they take that next step to speed the data updates in the future.
Anything they can do to get the info quicker is good. I hope they take that next step to speed the data updates in the future.
This post was edited on 8/14/25 at 8:23 pm
Posted on 8/14/25 at 8:24 pm to ragincajun03
Suing Roblox is much more important than this.
Posted on 8/14/25 at 8:29 pm to billjamin
It certainly makes more sense, when you consider the current AG used to be the go to lobbyist for Medicaid providers that found themselves in the crosshairs of the AG’s Medicaid fraud control unit.
Posted on 8/14/25 at 8:50 pm to Spankum
quote:
just because someone dies, that does not mean their final month(s) in a nursing home or hospital/hospice does not have to be paid.
Who said it did?
Posted on 8/14/25 at 8:54 pm to ragincajun03
the people on medicare arent defrauding, its the providers that are doing it
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