HHS watchdog finds $207M Medicaid payments for deceased
The Health and Human Services Office of Inspector General released a nationwide audit on Dec. 23, 2025 finding that Medicaid managed-care programs paid more than $207.5 million between July 2021 and July 2022 on behalf of people who were already dead, highlighting longstanding data‑matching failures across multiple states. The report urges greater federal sharing of the Social Security Administration’s Full Death Master File and notes a new requirement in Republicans’ One Big Beautiful Bill that, starting in 2027, will force state Medicaid agencies to quarterly audit their provider and beneficiary lists against that database to clamp down on improper payments.
📌 Key Facts
- HHS OIG identified over $207.5 million in improper Medicaid managed‑care payments for deceased enrollees from July 2021 to July 2022.
- The watchdog says such errors are persistent across states and recommends broader federal sharing of SSA’s Full Death Master File to help states detect deaths.
- A provision in the One Big Beautiful Bill, signed by President Trump, will require state Medicaid agencies from 2027 onward to run quarterly audits of their rolls against the Full Death Master File.
- Previous state‑level audits since 2016 had already uncovered about $289 million in similar erroneous Medicaid payments on behalf of dead beneficiaries.
- A separate Treasury pilot using temporary access to the Death Master File recovered more than $31 million in improper federal payments to deceased people.
📊 Relevant Data
In 2022, total Medicaid expenditures were $824 billion, making the $207 million in improper payments for deceased enrollees approximately 0.025% of total spending.
Medicaid and CHIP Expenditures by Service Category — Medicaid.gov
As of 2022, Hispanic people comprise 30.8% of Medicaid enrollees compared to 19.7% of the U.S. population, Black people comprise 20.8% of enrollees compared to 13.6% of the population, and White non-Hispanic people comprise about 40% of enrollees compared to 58% of the population.
What the data says about Medicaid — Pew Research Center
The vast majority of improper Medicaid payments, including those for deceased enrollees, stem from documentation mistakes and administrative errors rather than fraud.
What Are 'Improper' Medicaid Payments, and Are They as High as a New Trump Appointee Claims? — KFF Health News