Department of Health and Human Services 

OFFICE OF 

INSPECTOR GENERAL 

JUNE GIBBS BROWN 

Inspector General 

MARCH 2000 

OEI-03-99-00200 

Medicare Payments for Services 

After Date of Death 
OFFICE OF INSPECTOR GENERAL 

The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, is to 

protect the integrity of the Department of Health and Human Services programs as well as the 

health and welfare of beneficiaries served by them. This statutory mission is carried out through a 

nationwide program of audits, investigations, inspections, sanctions, and fraud alerts. The 

Inspector General informs the Secretary of program and management problems and recommends 

legislative, regulatory, and operational approaches to correct them. 

Office of Evaluation and Inspections 

The Office of Evaluation and Inspections (OEI) is one of several components of the Office of 

Inspector General. It conducts short-term management and program evaluations (called 

inspections) that focus on issues of concern to the Department, the Congress, and the public. The 

inspection reports provide findings and recommendations on the efficiency, vulnerability, and 

effectiveness of departmental programs. 

OEI's Philadelphia Regional Office prepared this report under the direction of Robert A. Vito, 

Regional Inspector General, and Linda M. Ragone, Deputy Regional Inspector General. Principal 

OEI staff included: 

REGION HEADQUARTERS 

David Graf, Project Leader Stuart Wright, Program Specialist 

Tara Schmerling, Program Analyst Brian Ritchie, Technical Support Staff 

To obtain copies of this report, please call the Philadelphia Regional Office at 1-800-531-9562. 

Reports are also available on the World Wide Web at our home page address: 

http://www.dhhs.gov/progorg/oei 
EXECUTIVE SUMMARY 

PURPOSE 

To determine if Medicare is paying claims with service dates after a beneficiary’s death. 

BACKGROUND 

The Health Care Financing Administration (HCFA), which administers the Medicare 

program, contracts with fiscal intermediaries and carriers to process claims. In 1991, 

HCFA established the Common Working File (CWF) to improve claims processing in the 

Medicare program. 

Under the CWF system, intermediaries and carriers send the claim information to one of 

nine CWF host sites for approval. These host sites are designated intermediaries and 

carriers responsible for maintaining the claims data received from other contractors. At 

the host sites, checks are performed on the claim for consistency, entitlement, and 

duplication of services. 

The CWF host sites receive updated beneficiary information, including date of death, from 

HCFA’s Enrollment Database on a daily basis. The data contained in the Enrollment 

Database is received daily from the Social Security Administration and the Railroad 

Retirement Board. In addition to receiving date of death information from the Enrollment 

Database, the CWF receives some date of death information directly from institutional 

claims submitted by intermediaries. 

For this inspection, we analyzed HCFA’s Enrollment Database and a 1 percent sample of 

National Claims History data to identify services that started after a beneficiary’s date of 

death. We also surveyed selected intermediaries and carriers asking about their 

procedures for identifying and recovering payments made for deceased beneficiaries. 

FINDINGS 

Medicare paid $20.6 million in 1997 for services that started after a beneficiary’s 

date of death 

Medicare paid an estimated $20.6 million in 1997 for services where the beneficiary’s date 

of death preceded the start date of the service. Medicare had not yet received date of 

death information at the time the claim was processed for $12.6 million (of $20.6 million) 

Medicare Payments for Services After Date of Death 1 OEI-03-99-00200 
of the services paid. Most of these claims (75 percent) were processed within 45 days of 

the beneficiary’s date of death. 

Medicare paid $8 million (of $20.6 million) for services where the beneficiary’s date of 

death was posted in its system at the time the claim was processed. Over half ($4.8 

million) was for durable medical equipment (DME) claims. We also found some payments 

for Part A and Part B services where the Enrollment Database and CWF files contained 

different dates of death. 

Medicare does not have uniform post-payment procedures to identify and recover 

payments for deceased beneficiaries 

Of the 15 contractors we surveyed, only 2 had post-payment procedures in place to 

identify payments for deceased beneficiaries. Four other contractors are in the process of 

developing review procedures. 

RECOMMENDATIONS 

One piece of information that the Common Working File (CWF) uses when processing a claim is 

a beneficiary’s date of death. We found that proper payment of a claim depends on (1) the receipt 

of date of death information before the claim is processed or (2) accurate system edits based on 

date of death information already in the CWF system. In either case, we believe that payments 

should not be made for services starting after a beneficiary’s date of death. Therefore we 

recommend: 

The HCFA should require Medicare contractors to conduct annual post-payment 

reviews to identify and recover payments for services after death 

Our findings show that HCFA made substantial payments for services where the 

beneficiary’s date of death was not yet posted at the CWF at the time the claim was 

processed and approved for payment. Because claims like these cannot be denied prior to 

payment (since the date of death is not in the CWF system), we recommend that HCFA 

require their contractors to conduct annual post-payment reviews to identify and recover 

these payments. 

We also found that contractors’ internal claims processing systems may be missing a 

significant amount of beneficiary date of death information. Therefore, HCFA should 

coordinate with their contractors to ensure they have the most up-to-date beneficiary date 

of death information before performing their post-payment reviews. 

Medicare Payments for Services After Date of Death 2 OEI-03-99-00200 
The HCFA should revise their CWF system edit to ensure that DME payments are 

not made for deceased beneficiaries 

We found particular problems relating to DME payments for deceased beneficiaries when 

the CWF had date of death information at the time the claim was processed and approved 

for payment. We recommend that HCFA revise their current CWF edit to deny all DME 

claims where the start dates of service occur after a beneficiary’s death. We believe that 

$4.8 million in 1997 payments for deceased beneficiaries would have been avoided had 

such an edit existed. In addition, we believe that HCFA policy should require that start 

and ending dates for DME services accurately reflect the service period. 

The HCFA should periodically reconcile date of death information between the 

Enrollment Database and CWF files 

We found that for some beneficiaries, discrepancies existed between the dates of death 

posted on the Enrollment Database and the dates of death posted at the CWF. Inaccurate 

date of death information can cause claims to be paid incorrectly and can also affect the 

accuracy of post-payment reviews. Therefore, we recommend that HCFA periodically 

reconcile the date of death information to ensure that accurate dates of death are 

contained in both files. 

AGENCY COMMENTS 

The HCFA concurred with our recommendations. In April 1999, HCFA completed their 

own program vulnerability analysis of this issue and developed an action plan to address 

the issues identified in their report. To specifically address our recommendations, HCFA 

stated that they would (1) fund pilot projects for a subset of Medicare contractors to 

identify and investigate improper payments for deceased beneficiaries, (2) require all 

contractors to perform post-payment reviews as part of their FY 2001 Budget 

Performance Requirements, (3) establish the system changes necessary to revise their 

Common Working File edit, and (4) work to reconcile date of death information while 

controlling contractors’ workloads. The full text of HCFA’s comments can be found in 

Appendix B. 

Medicare Payments for Services After Date of Death 3 OEI-03-99-00200 
TABLE OF CONTENTS 

EXECUTIVE SUMMARY .................................................... 1

INTRODUCTION .......................................................... 5

FINDINGS ................................................................ 9

Payments After Death .................................................. 9

Identification and Recovery of Payments After Death .......................... 11

RECOMMENDATIONS .................................................... 12

APPENDICES

A: Estimates and Confidence Intervals ..................................... 14

B. Agency Comments ................................................. 17

Medicare Payments for Services After Date of Death 4 OEI-03-99-00200 
INTRODUCTION 

PURPOSE 

The purpose of this inspection is to determine if Medicare is paying claims with service 

dates after a beneficiary’s death. 

BACKGROUND 

The Health Care Financing Administration (HCFA), which administers the Medicare 

program, contracts with companies called fiscal intermediaries and carriers to process 

claims. Fiscal intermediaries reimburse institutional inpatient services under Medicare Part 

A and outpatient claims under Part B. The types of institutional providers submitting 

claims to intermediaries include hospitals, skilled nursing facilities, and home health 

agencies. Carriers reimburse all other Part B claims including claims for services provided 

by physicians and medical suppliers. Four carriers called durable medical equipment 

regional carriers (DMERCs) process claims for durable medical equipment, prosthetics, 

orthotics, and supplies. 

Claims Processing 

In 1991, HCFA established the Common Working File (CWF) to improve claims 

processing in the Medicare program. Under the CWF system, intermediaries and carriers 

no longer contact HCFA directly to verify information such as beneficiary entitlement and 

benefit status before paying a claim. Instead, they send the claim information to one of 

nine CWF host sites. The CWF host sites are designated intermediaries and carriers 

responsible for maintaining the claims data received from other contractors. 

Before sending a claim to the CWF host sites, intermediaries and carriers enter the claim 

into their processing system, perform consistency and utilization edits on the claim, and 

calculate a payment amount. Then they send the claim to one of the host sites. At the 

host sites, checks are performed on the claim for consistency, entitlement, and duplication 

of services. Once the host sites perform these edits, they authorize the intermediary or 

carrier to pay the claim, reject the claim, or hold the claim until more information is 

obtained. 

Date of Death Information 

The CWF host sites receive updated beneficiary information, including date of death, from 

HCFA’s Enrollment Database on a daily basis. The Enrollment Database contains 

Medicare Payments for Services After Date of Death 5 OEI-03-99-00200 
information for each beneficiary ever enrolled in Medicare including personal identifiers 

such as name and social security number, demographic data such as date of birth and date 

of death, and entitlement information including start and termination dates. The data 

contained in the Enrollment Database is received daily from the Social Security 

Administration’s (SSA) Master Beneficiary Record which contains demographic and 

entitlement data on all Medicare beneficiaries. The SSA can be notified of a beneficiary’s 

death in a number of ways including reports from relatives, funeral homes, or the postal 

service. 

In addition to receiving date of death information from the Enrollment Database, the CWF 

receives some date of death information directly from institutional claims submitted by 

intermediaries. On these claims, the ending date of service indicates the date of the 

beneficiary’s death. 

Program Vulnerability 

In April 1999, HCFA issued a draft report which identified payments for deceased 

beneficiaries as a program vulnerability. According to HCFA, this vulnerability stems 

from the late posting of a beneficiary’s date of death to the SSA and the subsequent 

posting of this information to the CWF. The HCFA has notified their contractors of this 

vulnerability and at their 1999 benefit integrity training sessions suggested that contractors 

perform data analysis to identify billings for deceased beneficiaries. 

METHODOLOGY 

This inspection focused on the receipt of data at the CWF level to determine if Medicare 

paid claims for services after a beneficiary’s date of death. We did not evaluate whether 

or not the SSA received beneficiary date of death information in a timely manner. 

Claims Data 

We gathered all 1997 claims for a 1 percent sample of Medicare beneficiaries using 

HCFA’s National Claims History file. To identify services that started after a beneficiary’s 

date of death, we first developed a list of unique beneficiary identification numbers in the 

sample. We then matched those numbers against HCFA’s Enrollment Database, checking 

for beneficiaries who had died prior to January 1, 1998. We then extracted from the 1 

percent sample all claims associated with these deceased beneficiaries. We calculated the 

number of services and dollars paid where the start date of service was after the date of 

death. We used the amount that Medicare reimbursed, which does not include beneficiary 

co-payments or deductibles, to calculate dollars paid. 

Medicare Payments for Services After Date of Death 6 OEI-03-99-00200 
For the purposes of this report, when we refer to Part A services, we are referring to both 

Part A inpatient services as well as Part B outpatient services handled by fiscal 

intermediaries. When we refer to Part B services, we are referring to Part B services 

handled by carriers. When we refer to durable medical equipment (DME) services, we are 

referring to the durable medical equipment, prosthetics, orthotics, and supplies handled by 

the DMERCs. 

Variables used in analysis. To determine if the CWF had a beneficiary’s date of death at 

the time the claim was processed, we used information from the Enrollment Database and 

National Claims History files. To determine when the CWF received the beneficiary’s 

date of death, we used the Enrollment Database variable “SSA RRB Action Processing 

Date” (Last Action Date). This variable is defined as the date of the last Social Security 

Administration’s Master Beneficiary Record (MBR) or Railroad Retirement Board 

change. 

To determine when Medicare processed the claim, we used the National Claims History 

variable “CWF Accretion Date” (Processing Date). This variable is defined as the date the 

institutional or Part B claim is accreted (posted/processed) to the MBR at the CWF host 

site and authorization for payment is returned to the fiscal intermediary or carrier. 

The HCFA informed us that the Enrollment Database ledger account file (LAF) codes may 

be more indicative than the Last Action Date in determining when a beneficiary’s date of 

death is recorded at the Enrollment Database. However, we compared the Last Action 

Date to the LAF code defined as the “beneficiary payment status change date” (LAF date). 

Our analysis showed that the LAF date was either the same or prior to the Last Action 

Date. To be conservative in determining when Medicare had the beneficiary’s date of 

death, we used the Last Action Date in our analysis. 

Comparing Last Action Date to Processing Date. We compared the Last Action Date 

to the Processing Date. Usually it takes one day for the date of death information to go 

from the SSA to the Enrollment Database and another day to go from the Enrollment 

Database to the CWF. We added three days to the Last Action Date to allow for the 

maximum time it would take for the date of death data to get from the SSA to the CWF. 

If the Processing Date was before the Last Action Date (plus 3 days), we determined that 

the CWF host site processed the claim before the date of death was in the system. If the 

Processing Date was after the Last Action Date (plus 3 days), we determined that the 

CWF host site processed the claim after the date of death was in the system. 

We performed further analysis on beneficiaries with Part A and Part B services where it 

appeared that the claim was processed after the date of death was posted at the CWF. In 

order to check these dates of death, we reviewed the CWF’s Health Insurance Master 

Record file. Our analysis showed that, for a few services, the date of death had not made 

Medicare Payments for Services After Date of Death 7 OEI-03-99-00200 
it from the Enrollment Database to the CWF. For these beneficiaries, there was no date of 

death present on the CWF’s Health Insurance Master Record file. Therefore, in our 

calculations we grouped the services for these beneficiaries with the services where the 

CWF processed the claim before the date of death was in the system. 

Percentage estimates and corresponding 95 percent confidence intervals for our data were 

computed using standard statistical formulas for a simple random sample. Point estimates 

and confidence intervals for all statistics presented in this report are in Appendix A. 

Survey Data 

We mailed questionnaires to 15 contractors asking about their post-payment procedures 

for identifying and recovering payments made for deceased beneficiaries. We selected the 

top contractors based on their 1997 payments for deceased beneficiaries. Whether or not 

contractors had post-payment procedures in place in 1997 is independent of the amount of 

their 1997 payments for deceased beneficiaries. Our sample included five fiscal 

intermediaries, six carriers, and all four DMERCs. 

_____________ 

This inspection was conducted in accordance with the Quality Standards for Inspections 

issued by the President’s Council on Integrity and Efficiency. 

Medicare Payments for Services After Date of Death 8 OEI-03-99-00200 
FINDINGS 

Medicare paid $20.6 million in 1997 for services that started 

after a beneficiary’s date of death 

Medicare paid an estimated $20.6 million in 1997 where the beneficiary’s date of death 

preceded the start date of the service. The $20.6 million represents $9.2 million in durable 

medical equipment (DME) claims, $10 million in Part A claims, and $1.4 million in Part B 

claims. 

For some of these services, our analysis revealed that the CWF had not yet received the 

beneficiary’s date of death at the time the claim was processed. However in other cases, 

the CWF had the beneficiary’s date of death in its system when the claim was processed 

and approved for payment. 

Medicare had not yet received beneficiary’s date of death for over half the 

payments 

Medicare paid $12.6 million (of $20.6 million) for services where the beneficiary’s date 

of death was not yet posted at the CWF at the time the claim was processed. This $12.6 

million consisted of $4.5 million in DME claims, $6.9 million in Part A claims, and $1.2 

million in Part B claims. Most of these claims (75 percent) were processed within 45 days 

of the beneficiary’s date of death. 

Medicare had received beneficiary’s date of death for almost half the payments 

Medicare paid $8 million (of $20.6 million) for services where the beneficiary’s date of 

death was posted in the CWF at the time the claim was processed and approved for 

payment. Over half ($4.8 million) was for DME claims. The rest of the payments 

involved different dates of death in the Enrollment Database and CWF files. 

Payments for DME services after beneficiary’s date of death 

We found that Medicare paid $4.8 million for DME services even though the CWF 

contained the beneficiary’s date of death at the time the claim was approved for payment. 

Rental services accounted for $3.5 million of the $4.8 million in DME services. The 

remaining payments consisted of non-rental DME services such as lump sum payments for 

DME, orthotics, and prosthetics and enteral nutrients. The start and ending dates for 

these DME services occurred within 30 days of a beneficiary’s date of death. 

Medicare Payments for Services After Date of Death 9 OEI-03-99-00200 
We are aware that the CWF has an edit that allows for the payment of DME rental claims 

up to 30 days after a beneficiary’s date of death. This edit takes the beneficiary’s date of 

death, adds 30 days, and compares this date with the service ending date to determine if 

the claim should be paid. If the service ending date is before the beneficiary’s date of 

death (plus 30 days) then the CWF allows the claim. If the service ending date is after the 

beneficiary’s date of death (plus 30 days) then the CWF denies the claim. 

It is our understanding that this edit was designed to allow for a full month’s rental 

payment if the beneficiary dies within the rental period. For example, if the rental period 

for a DME service is March 1st (i.e., start date) thru March 31st (i.e., ending date) and the 

beneficiary dies on March 15th, the rental service for the month of March would be 

properly allowed since March 31st (i.e., service ending date) is before April 15th (i.e., date 

of death plus 30 days) and the beneficiary died within the rental period. Additionally, a 

claim for the next rental period (April 1st -April 30th ) would be properly denied. 

However, all the rental claims that we identified had the same start and ending dates of 

service; therefore Medicare’s payment of these claims was actually for the rental period 

following a beneficiary’s death. For example, if the start and ending dates of service for 

an April rental period are April 1st and the beneficiary dies on March 15th, the CWF would 

improperly allow the claim for the month of April. In this case, the edit says to allow the 

claim since April 1st (service ending date) is before April 15th (date of death plus 30 days). 

We also found similar payments made for DME claims that were not rental services. For 

these claims, the start date of service was after the beneficiary’s date of death and the 

service ending date was within 30 days of the beneficiary’s death. It appears that the 

CWF edit was applied not only to rental services but also non-rental services. 

Some Part A and Part B services had different dates of death in the Enrollment 

Database and CWF files 

We found some Part A and Part B services where the Enrollment Database and CWF files 

contained different dates of death. As previously mentioned, the CWF can receive date of 

death information from both the Enrollment Database and from Part A claims. For the 

services we identified, the CWF file reflected the dates of death contained on a Part A 

claim which was different from the dates of death posted on the Enrollment Database. We 

found no indication of which file contained the accurate date of death. 

Medicare Payments for Services After Date of Death 10 OEI-03-99-00200 
Medicare does not have uniform procedures to identify and 

recover payments for deceased beneficiaries 

Of the 15 contractors we surveyed, only two durable medical equipment regional carriers 

(DMERCs) had post-payment procedures in place to identify and recover payments made 

for deceased beneficiaries. These two DMERCs identified approximately $1.2 million 

over a 2-year period for services paid after a beneficiary’s date of death. In contrast, we 

estimate that these same DMERCs paid $4.9 million in payments for deceased 

beneficiaries in 1997 alone. Four other contractors (three carriers and one intermediary) 

are in the process of developing post-payment procedures. 

Three contractors specifically stated that they obtain (or will obtain) their beneficiary date 

of death information from their own internal claims processing system. It is our 

understanding that contractors generally receive updated beneficiary information, 

including date of death, from the CWF when a claim is returned to the contractors. 

If a contractor submits a claim for a deceased beneficiary before the CWF has the 

beneficiary’s date of death in its system, this claim will be approved for payment (barring 

any other problems with the claim). Moreover, once the CWF is notified of the 

beneficiary’s date of death, the contractor’s internal system is only updated if the 

contractor sends another claim to the CWF. Therefore, it is possible that the contractors’ 

systems may never be updated with this beneficiary date of death information. In turn, 

when the contractors perform their post-payment reviews looking for payments made for 

deceased beneficiaries, they may miss a significant number of payments because the 

beneficiary’s date of death was never posted to their own internal claims processing 

system. 

Medicare Payments for Services After Date of Death 11 OEI-03-99-00200 
RECOMMENDATIONS 

One piece of information that the Common Working File (CWF) uses when processing a claim is 

a beneficiary’s date of death. We found that proper payment of a claim depends on (1) the receipt 

of date of death information before the claim is processed or (2) accurate system edits based on 

date of death information already in the CWF system. In either case, we believe that payments 

should not be made for services starting after a beneficiary’s date of death. Therefore we 

recommend: 

The HCFA should require Medicare contractors to conduct annual 

post-payment reviews to identify and recover payments for services 

after death 

Our findings show that HCFA made substantial payments for services where the 

beneficiary’s date of death was not yet posted at the CWF at the time the claim was 

processed and approved for payment. Because claims like these cannot be denied prior to 

payment (since the date of death is not in the CWF system), we recommend that HCFA 

require their contractors to conduct annual post-payment reviews to identify and recover 

these payments. 

We also found that contractors’ internal claims processing systems may be missing a 

significant amount of beneficiary date of death information. Therefore, HCFA should 

coordinate with their contractors to ensure they have the most up-to-date beneficiary date 

of death information before performing their post-payment reviews. 

The HCFA should revise their CWF system edit to ensure that DME 

payments are not made for deceased beneficiaries 

We found particular problems relating to DME payments for deceased beneficiaries when 

the CWF had date of death information at the time the claim was processed and approved 

for payment. We recommend that HCFA revise their current CWF edit to deny all DME 

claims where the start dates of service occur after a beneficiary’s death. We believe that 

$4.8 million in 1997 payments for deceased beneficiaries would have been avoided had 

such an edit existed. In addition, we believe that HCFA policy should require that start 

and ending dates for DME services accurately reflect the service period. 

Medicare Payments for Services After Date of Death 12 OEI-03-99-00200 
The HCFA should periodically reconcile date of death information 

between the Enrollment Database and CWF files 

We found that for some beneficiaries, discrepancies existed between the dates of death 

posted on the Enrollment Database and the dates of death posted at the CWF. Inaccurate 

date of death information can cause claims to be paid incorrectly and can also affect the 

accuracy of post-payment reviews. Therefore, we recommend that HCFA periodically 

reconcile the date of death information to ensure that accurate dates of death are 

contained in both files. 

AGENCY COMMENTS 

The HCFA concurred with our recommendations. In April 1999, HCFA completed their 

own program vulnerability analysis of this issue and developed an action plan to address 

the issues identified in their report. To specifically address our recommendations, HCFA 

stated that they would (1) fund pilot projects for a subset of Medicare contractors to 

identify and investigate improper payments for deceased beneficiaries, (2) require all 

contractors to perform post-payment reviews as part of their FY 2001 Budget 

Performance Requirements, (3) establish the system changes necessary to revise their 

Common Working File edit, and (4) work to reconcile date of death information while 

controlling contractors’ workloads. The full text of HCFA’s comments can be found in 

Appendix B. 

Medicare Payments for Services After Date of Death 13 OEI-03-99-00200 
APPENDIX A 

Estimates and Confidence Intervals

The tables below contain statistical estimates presented in the findings section of this report. 

Point estimates and corresponding 95 percent confidence intervals based on a 1 percent sample of 

HCFA’s National Claims History file were computed using standard statistical formulas for a 

simple random sample. 

Table 1. 1997 Medicare Payments for Services After Date of Death 

Type of Service Point Estimate 95% Confidence Interval 

DME $9,243,771 $8,300,536 - $10,187,007 

Part A $9,957,253 $3,367,049 - $16,547,457 

Part B $1,434,529 $1,237,944 - $1,631,114 

Total $20,635,553 $13,482,383 - $27,788,723 

Table 2. 1997 Payments Where Medicare Did Not Have Beneficiary’s Date of Death 

When Claim was Processed 

Type of Service Point Estimate 95% Confidence Interval 

DME $4,480,453 $3,786,867 - $5,174,038 

Part A $6,877,164 $3,162,325 - $10,592,003 

Part B $1,215,769 $1,031,598 - $1,399,940 

Total $12,573,386 $8,353,906 - $16,792,866 

Medicare Payments for Services After Date of Death 14 OEI-03-99-00200 
APPENDIX A 

Table 3. Percentage of Claims Processed Within 45 Days of the Beneficiary’s Date of Death 

When Date of Death Was Not in CWF System at the Time Claim was Processed 

Point Estimate 95% Confidence Interval 

Percentage of Claims Processed 

within 45 Days of the 

Beneficiary’s Date of Death 

74.82% 71.24% - 78.40% 

Table 4. 1997 Total Payments Where Medicare Had Beneficiary’s Date of Death When 

Claim was Processed 

Point Estimate 95% Confidence Interval 

Total Payments Where 

Medicare Had Beneficiary’s 

Date of Death 

$8,062,167 * $2,284,074 - $13,840,260 

* In the findings of this report, we used $8 million as the estimate. 

Table 5. 1997 DME Payments Where Medicare Had Beneficiary’s Date of Death When 

Claim Was Processed 

Type of Service Point Estimate 95% Confidence Interval 

DME Total $4,763,318 $4,126,468 - $5,400,169 

DME Rental $3,506,073 $3,113,665 - $3,898,481 

Medicare Payments for Services After Date of Death 15 OEI-03-99-00200 
APPENDIX A 

Table 6. Two DMERCs’ 1997 Payments for Services After Date of Death 

Point Estimate 95% Confidence Interval 

Two DMERCs’ 1997 

Payments for Services 

After Date of Death 

$4,940,063 $4,459,786 - $5,420,340 

Medicare Payments for Services After Date of Death 16 OEI-03-99-00200 
APPENDIX B 

Comments From the Health Care Financing Administration

Medicare Payments for Services After Date of Death 17 OEI-03-99-00200 
APPENDIX B 

Medicare Payments for Services After Date of Death 18 OEI-03-99-00200 
APPENDIX B 

Medicare Payments for Services After Date of Death 19 OEI-03-99-00200 
APPENDIX B 

Medicare Payments for Services After Date of Death 20 OEI-03-99-00200 
APPENDIX B 

Medicare Payments for Services After Date of Death 21 OEI-03-99-00200