Report Materials
Wisconsin made 1,654 capitation payments totaling $589,478 ($347,822 Federal share) on behalf of deceased beneficiaries. We confirmed that all beneficiaries associated with these capitation payments were deceased.
Wisconsin did not always identify and process Medicaid beneficiaries' death information. Although the State's eligibility system regularly interfaced with Federal data exchanges that identify dates of death, caseworkers did not always receive notification that beneficiaries had died or did not correctly input the dates of death in the system.
18-A-05-163.01 to CMS - Closed Implemented
Closed on
03/28/2019
We recommend that the State agency recover unallowable payments totaling $589,478 from MCOs and refund $347,822 (Federal share) to the Federal Government
18-A-05-163.02 to CMS - Closed Implemented
Closed on
03/28/2019
We recommend that the State agency identify and recover capitation payments made on behalf of deceased beneficiaries before and after our audit period, and repay the Federal share of amounts recovered
18-A-05-163.03 to CMS - Closed Implemented
Closed on
03/28/2019
We recommend that the State agency strengthen its policies and procedures for identifying deceased beneficiaries and correctly entering DODs in CARES to ensure that DODs are recorded in a timely manner to prevent unallowable payments.
View in Recommendation Tracker
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Notice
This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.