According to an inspector general audit, the Centers for Medicaid and Medicare Services distributed $9.3 million worth of food, aid, cash, medical benefits and other services to illegal, undocumented immigrants in 2013 and 2014.
The audit makes it clear that Medicare benefits are usually only allowable when they are rendered to beneficiaries who have been determined by the Social Security Administration to be a natural born or naturalized United States citizen.
Medicare, the report goes on to clarify, is not intended or allowed to pay for any services that have been or will be rendered to any person or persons who are within U.S. borders illegally on the date the service was delivered.
Exceptions to these rules are rare, and are generally only made under extreme circumstances, and more often than not- require an unusual level of advocacy for those who will benefit from these exceptions. However, nearly 500 exceptions have been made in recent years- exceptions that have gone virtually undetected until now.
The laws that govern Medicare require the agency to do their due diligence and to make absolutely certain that any payments made for Medicare services are not authorized for persons who are unlawfully in the country at the time medical services were given to them.
The Medicare agency is strictly mandated to take all of the necessary steps to prevent any improper payments from being made and to recoup these improper payments if and when they are discovered.
The audit said, “Centers for Medicaid and Medicare Services had policies in place and had well-known procedures ready to prevent any payments for Medicare services from being delivered to illegal immigrant beneficiaries in conformity with standards as well as long-standing Federal policy, but it did not consistently follow these, or any such, well-outlined regulations.”
The audit has said in no uncertain terms that these agencies had everything they needed to vet these beneficiaries, to discover their illegal status and all of the mechanisms to deny and recover all unauthorized payments made to their health care providers.
The report continues, “It has been found that the Medicare agency is fully and duly capable of determining whether beneficiaries are present in the country lawfully or unlawfully by acquiring pertinent data from Social Security.”
“When these agencies’ own internal data systems did not give any indication until after a claim was submitted and processed that a beneficiary was not legally present on U.S. soil, these agencies had sufficient policies, procedures, and ability to discover the discrepancy and to recover any payment rendered for services given to these undocumented, illegal migrants,” the report went on. “But, in most cases, it either did not follow the procedure for discovering the beneficiary’s illegal status and when it did discover that the beneficiary was not legally present in this country- it did not follow the rules or procedures to recover the payment.”
The audit also discovered that in the years 2013 and 2014, the Medicare agency had paid out to no fewer than 14,537 claims, which in total accounted for $9,267,397 in payments to more than 481 illegal immigrants.
“When Medicare had paid a medical care provider for their services delivered to beneficiaries who were subsequently found to have been illegally present in the U.S. at the time the services were rendered, Medicare regulations state clearly that those same fallaciously made payments should be fully recouped at the earliest point possible,” the audit said.
Acting administrator at the Centers for Medicaid and Medicare Services, Andy Slavitt, said the agency has every intention to make an effort to recover the payments. He said, “CMS has pledged to make sure that all of the improper payments in the future will not be made for health care services that have been provided to those unlawfully present in the country,”
Slavitt went on to say, “CMS will carefully review all of the overpayments that were referred to by the inspector general and identify any and all overpayments equal to or greater than $1,000.”
“CMS will make every attempt to return these overpayments to the government,” he said. “At the end of this sizable collection effort, CMS will deliver a thorough cost-benefit analysis in order to make a determination of whether or not CMS should pursue other similarly disposed overpayments that may be made in the future.”
At a time when Americans are struggling, and legitimate claims for aid are being made by people who have, to no fault of their own, fallen on hard times- this willfully wasteful use of taxpayer monies is an insult to honest and hard-working citizens all over the country.
Regards,
Ethan Warrick
Editor
Wealth Authority
