Research Paper

The Office of Inspector General found Colorado made at least $3.

The Office of Inspector General found Colorado made at least $3.8 million in unallowable Medicaid payments to managed care organizations on behalf of dead enrollees, and incorrectly reported an additional $2.2 million in expenditures to CMS, exposing weaknesses in oversight and fiscal controls within the state’s Medicaid program.

URL https://oig.hhs.gov/reports/all/2025/colorado-made-capitation-payments-to-managed-care-organizations-after-enrollees-deaths/

TLDR;

This shocking OIG report just dropped another anvil on Colorado’s already crumbling Medicaid empire: $3.8 million in unallowable capitation payments funneled to managed care giants for dead enrollees—plus $2.2 million in falsely reported costs to CMS. That’s taxpayer cash handed to insurance middlemen for people who’ve been pushing up daisies—some for months, even years after their deaths were on file.

“Colorado continued to make capitation payments… after the date of death.”
— HHS Office of Inspector General

Let that sink in.
While real patients wait weeks for approvals and honest providers fight for scraps, bureaucrats let the gravy train roll—paying full monthly premiums to HMOs for ghost members. And when caught? They underreported the damage to federal auditors by $2.2 million, cooking the books to dodge scrutiny.

This Isn’t Oversight—It’s Neglect

The state knew these enrollees were deceased:

Social Security Master Death File had the dates
State eligibility systems were updated
Yet no one flipped the switch

Result?

Over $6 million total in improper claims and reporting errors—and that’s just what the feds caught.

Same Song, Different Verse

This is MedRide 2.0:

Endless extensions
Slap-on-the-wrist audits
Zero consequences until the feds step in

The Department of Health Care Policy & Financing claims they’re “reviewing” the findings.
Translation: We’ll drag our feet until the next scandal.

Who Suffers?

Seniors skipping meds because copays are too high
Disabled Coloradans stuck on waitlists
Taxpayers—you—funding premiums for the deceased while your own healthcare costs skyrocket

Fix It. Now.

No more “we’ll get to it” excuses. Demand:

Automated, real-time death matching—same day cutoff
Clawback every dollar from MCOs—with interest
Public dashboard tracking improper payments
Independent audits—not in-house whitewashes

Capitation for corpses? That ends today.

The Bottom Line

Colorado’s Medicaid isn’t just broken—it’s bleeding.
$15 billion a year, and we can’t stop paying dead people?

Enough.
Hold the bureaucrats accountable.
Protect the living.
Stop the grift.

It’s not oversight failure—it’s willful blindness.
Time to clean house.

Authors: Office of the Inspector General