Louisiana paid $10M to insurers for dead Medicaid patients, audit says

In the last six years, the Louisiana Department of Health has paid nearly $10 million to insurance companies for Medicaid beneficiaries who had already died, according to a new state audit.

The progress report, conducted by state Legislative Auditor Mike Waguespack and shared with legislators last week, found LDH successfully verified most deaths, but it "could identify additional deceased Medicaid beneficiaries if it included additional third-party data sources, such as obituaries, the Social Security Administration's death master file and other states' vital records databases," data analyst Chris Magee said in a podcast about the findings.

The missed deaths, which work out to roughly 174 per year, occurred between February 2019 and March 2025 under the administrations of both Republican Gov. Jeff Landry and former Democratic Gov. John Bel Edwards. The review was conducted, in part, to "further the goals of the Governor's Fiscal Responsibility Program, known as LA DOGE," the audit said.

The findings are not entirely surprising, considering the COVID-19 pandemic and a federal order that paused eligibility checks for part of that period, said Kevin Callison, a health economist at Tulane University.

"Ideally, it would be zero," Callison said. "But the reality is that it's just really difficult for state agencies to collect this data that comes from various different data sources and aggregate that and be able to use that to determine things like eligibility and mortality."

The report follows up on a similar 2017 review that also found deceased people still enrolled in Medicaid.

LDH administers Medicaid for about 1.6 million residents under a managed-care model, paying private insurers a fixed monthly rate per enrollee. That arrangement continues until the department confirms someone is no longer eligible.

The audit found LDH made about $9.6 million in per-member per-month payments for 1,072 people after their date of death. None had claims for services after death, which auditors said corroborated the findings.

Auditors identified the 511 deceased beneficiaries through obituaries, 210 through Louisiana vital records, 168 through the Social Security Administration's Death Master File, 133 through a combination of state records and third-party sources and 50 from vital records in 13 other states.

LDH said it plans to withhold about $4 million from upcoming managed-care payments to recoup a portion of the funds and agreed to incorporate additional data sources, including a more comprehensive SSA death file.

In a response to the findings, LDH Secretary Bruce Greenstein said the Department is "in the process of working with the U.S. Department of Treasury to gain the necessary approvals to receive the Social Security Administration Death Master File," and would use it to check deaths in the future.

Relatedly, Louisiana is gearing up to comply with new Medicaid work requirements as part of the One Big Beautiful Bill Act. The same data-accuracy hurdles could complicate enforcement. Verifying whether someone is dead or alive is less challenging than identifying whether somebody completed 80 hours of work or public service in the past 30 days, Callison said.

"You think, oh, well, it's easy to know if somebody's dead or not, right? That should be pretty straightforward, but even there, it's not perfect," Callison said.