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Colorado Audit Reveals $7 Million Paid for Deceased Medicaid Recipients

A federal audit found systemic issues in Colorado's Medicaid payment processes, leading to improper payments for nearly 9,000 deceased enrollees.

  • An audit by the U.S. Department of Health and Human Services estimated Colorado paid $7.3 million, including $3.8 million in federal funds, for Medicaid services to deceased individuals.
  • The improper payments, made between 2018 and 2020, stemmed from capitation payments, which provide insurers a fixed amount per enrollee regardless of service use.
  • The audit highlighted Colorado's lack of an automated system to track deaths during the period, with some payments processed even when deaths were known.
  • Colorado implemented an automated system in 2019 and attempted to recover some funds but did not collect payments for individuals no longer eligible for Medicaid.
  • State officials dispute parts of the audit, citing methodology concerns, while the Office of the Inspector General recommends Colorado repay $3.8 million in federal funds and address systemic issues.
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