A bill that would require the Oklahoma Health Care Authority to prevent deceased individuals from getting approved for Medicaid and ensure no payments or coverage are authorized on their behalf advanced through the Senate Health and Human Services Committee.
Sen. Jack Stewart, R-Yukon, who authored Senate Bill 1380, said he could not quantify how frequently this is occurring in Oklahoma, as he didn't review that with the state Medicaid agency. He said he would be glad to do so before the bill, which had its title stricken, moves to the Senate floor.
The legislation amends Oklahoma statute, which requires the Health Care Authority to verify the eligibility information of each applicant, to include “death record verification conducted immediately prior to approval.”
But the current statute already requires the Health Care Authority verify death records before awarding assistance under Medicaid.
Stewart’s bill adds that records shall be verified through, at a minimum, the Social Security Administration’s Death Master File and the State Department of Health’s system of vital statistics. A spokesperson for the Health Care Authority said in an email the agency is working on system changes to allow it to use those tools.
They said the agency currently uses internal claims data as part of its post-enrollment verification. This process allows the agency to enroll patients in Medicaid based on the information they attested to on their application. Then, it compares that information to data sources and requests additional documentation if needed.
During this verification process, the agency also uses Social Security Administration death data from the administration’s State Verification Exchange System Data Exchange connection and State Online Query System response, which are updated weekly and in real time, respectively.
“We currently act on death data as it is received from our internal claims and SSA data,” the spokesperson said. “Once data is received, that indicates a member may be deceased, it is processed and the family is sent a verification request which is due in 30 days and ends coverage the last day of the month due.”
Stewart’s bill would also require the Health Care Authority receive and review information regarding Medicaid enrollees that indicates a change in circumstances that may affect eligibility monthly instead of quarterly. It would also require OHCA to conduct monthly death record verification for all individuals enrolled in Medicaid.
The agency spokesperson said operational and system impacts of these reviews are still being assessed.
Discussion in committee
Sen. Carri Hicks, D-Oklahoma City, asked if the Health Care Authority is already conducting such reviews. Stewart said “evidently not to the 100%.”
“I don't know, it most likely is to some degree, but they say it's a national problem across the country and that Oklahoma's got some degree of guilt in that, in not catching all of them. Once a person has died, they remain on Medicaid rolls,” Stewart said.
That issue Stewart is referencing was recently addressed in a December 2025 watchdog report from the U.S. Department of Health and Human Services Office of Inspector General. It found that from July 2021 to 2022, Medicaid agencies made approximately $207 million in improper payments to managed care organizations for people who had already died.
State Medicaid agencies can contract with managed care organizations, which accept a set per-member-per-month capitation payment to coordinate enrollees’ care. In Oklahoma, this is called SoonerSelect, which mainly includes children, pregnant women and Medicaid expansion adults.
The analysis covered net capitation payments made by Medicaid agencies in 35 states, Puerto Rico and Washington D.C., on behalf of enrollees whose deaths preceded the monthly service period covered by the capitation.
But the report doesn’t cover Oklahoma, which did not have a comprehensive managed care system during its selected timeframe. The Health Care Authority transitioned from a fee-for-service model, where it paid providers directly, to paying managed care organizations to coordinate some enrollees' care a few years after the report.
Stewart’s bill also requires the Health Care Authority to recoup any funds expended on behalf of a deceased enrollee for capitated payments or services occurring after their date of death. Hicks asked who would be paying that cost if the person were deceased. The answer was unclear.
“The state would have to pay it back to somebody, I would think,” Stewart said. “They would probably go after the guilty party to begin with, I'm just assuming, and see if they could recuperate from a family that's collected when they should not have collected.”
The measure passed with 10 lawmakers voting in favor and two against it.
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