Washington, DC — Medicaid programs across the United States paid more than $207 million to health care providers on behalf of beneficiaries who had already died, according to a new nationwide audit released by the Department of Health and Human Services Office of Inspector General. The improper payments occurred between July 2021 and July 2022 and primarily involved managed care plans, marking the first comprehensive federal review of the issue across all states.
The watchdog agency said the problem is persistent and widespread, not confined to any single state. Investigators attributed the payments largely to outdated enrollment data and limited access by states to federal death records. At the center of the issue is the Social Security Administration’s Full Death Master File, a database containing more than 142 million death records dating back to 1899. Privacy and identity theft protections have long restricted how broadly the file can be shared.
A new provision included in Republicans’ “One Big Beautiful Bill,” signed into law earlier this year, is expected to change that. Beginning in 2027, state Medicaid agencies will be required to conduct quarterly audits of beneficiary and provider rolls against the death database. Federal officials believe the requirement will significantly reduce improper payments and improve program accuracy.
The report builds on years of prior audits that have identified nearly $289 million in similar payments since 2016. Earlier pilot programs using limited access to the death file have already recovered tens of millions in federal funds, suggesting broader access could yield substantial savings.
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