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Wisconsin Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries’ Deaths

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.

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Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201