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Using Medical Claim Data to Identify Aged Title XVI Recipients Who Are Deceased

October 03, 2016

Office Affiliation: The Office of Audit

Audit Report Number: A-08-14-24122

We issued this report to determine whether the Social Security Administration (SSA) could use medical claim data to identify aged Title XVI recipients who are deceased.

In our August 2012 review, Using Medicare Claim Data to Identify Deceased Beneficiaries, we determined SSA could use enhanced Medicare claim data to identify deceased Title II beneficiaries who were age 90 or older. Based on our recommendation, SSA implemented the Medicare Non-Utilization Project in September 2013. As of August 2016, SSA had identified about $165 million in improper payments to deceased Title II beneficiaries. As such, we believe using medical (Medicaid and Medicare) claim data would also be effective in identifying aged Title XVI recipients who are deceased.

We identified 436 Title XVI recipients who were age 90 or older and in current payment status as of October 2015. All recipients had an address in one of the top four Medicaid States (California, Florida, New York, and Texas). These recipients had no Medicaid or Medicare activity from 2011 through 2013 (the most recent 3 years of data available). We selected a random sample of 100 recipients for review.


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