1. Archive

Medicaid fees get life after death

A computer glitch causes millions in Medicaid credits to be improperly sent to health care providers.

The state Medicaid office made automatic payments of at least $3.2-million to health care providers on behalf of more than 6,000 dead patients.

The medical providers were paid for services to 6,238 Medicaid patients who died between February 1997 and July 1999, a recent audit found.

The state Auditor General's Office report found that most of the automatic claims were paid within three months of the person's death. However, about $600,000 in improper payments was paid to the health maintenance organizations, hospitals, pharmacies and nursing homes up to more than two years later.

The culprit is a computer system maintained by the Department of Health's Office of Vital Statistics and updated by the Department of Children and Families that didn't let other state agencies know about patient deaths before automatic claims were paid, according to the report.

"The Office (of Vital Statistics) should decrease the time it takes to process death certificates," state Auditor General William O. Monroe wrote last month.

That system has been upgraded, the Office of Vital Statistics said in the report.

"We're getting data faster than we used to," said Bruce Middlebrooks, spokesman for the Agency for Health Care Administration (AHCA), the agency that runs the Medicaid program.

Although significant, the $3.2-million still pales compared with the $1-billion shortfall already threatening Medicaid's health programs for Florida's neediest families.

That shortfall arose when state forecasters apparently low-balled the number of people who would qualify for Medicaid health coverage after losing eligibility for other programs such as welfare. To that, Gov. Jeb Bush has added the explanation that Florida was so aggressive in signing up poor kids for health insurance that Medicaid costs skyrocketed.

In addition to the state Auditor General's report, AHCA reviewed its own data and found $2.1-million went for claims for people who had already died in 1997. It was unclear Friday whether that was included in the $3.2-million identified by state auditors. So far, AHCA has recovered just over $800,000 of that, and that agency is reviewing information from 1998 and 1999.

The agency continues to recoup more Medicaid dollars wrongly paid to deceased patients, Middlebrooks said. It has nearly doubled the amount it got back last year _ $10.2-million _ compared with the $5.9-million it recouped in 1998.

"Recovery is a priority for us," Middlebrooks said.

The audit does not say whether the claims were fraud or error, although none have been forwarded to the state Attorney General's Office for investigation, and Middlebrooks said his agency does not suspect fraud.

The audit also cited county health departments and funeral homes for delaying the delivery of death certificates to the state, and said too many employees had access to the state death data base.

_ Information for the Associated Press was included in this report.