More than $91.6 million in Medicare payments went to services for illegal aliens in recent years

Article subtitle: 
Legal aliens are permitted to receive Medicare benefits
Article author: 
Caroline May
Article publisher: 
The Daily Caller
Article date: 
25 January 2013
Article category: 
National News
Article Body: 
Medicare payments to health care providers for services rendered to illegal aliens totaled more than $91.6 million from 2009 to 2011, a new report released by the Department of Health and Human Services Office of the Inspector General revealed.
The $91.6 million in claims went toward services for a 2,575 illegal aliens.
Centers for Medicare & Medicaid Services (CMS) records, however, identified over 29,100 beneficiaries that were in the country illegally at some point in the timeframe the IOG investigated.
The inspector general’s office limited its audit to those 2,575 to look “at whether CMS had adequate controls to prevent and detect improper payments for Medicare services rendered to unlawfully present individuals.”

Federal regulations prohibit Medicare payments from benefiting people in the country illegally. Legal aliens are permitted to receive Medicare benefits.

CAIRCO Research


The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) 

Audit (A-07-12-01116)
Medicare Improperly Paid Providers Millions of Dollars for Unlawfully Present Beneficiaries Who Received Services During 2009 Through 2011

Download the complete report


While Federal law permits Medicare payments for services rendered to an alien who is lawfully present in the United States, Medicare benefits are not allowable for aliens who are not lawfully present. If a Medicare claim was processed after the Centers for Medicare & Medicaid Services' (CMS) data systems indicated that a Medicare beneficiary was unlawfully present in the United States, CMS was able to prevent the payment. However, when CMS's systems did not indicate the unlawful presence status until after a claim had been processed, CMS was not able to detect and recoup the improper payment.