Improper payments and fraud remain chronic and costly difficulties for Medicaid and other government-funded programs. The GAO defines improper payments as payments that should not have been made or that were made in an incorrect amount (including overpayments and underpayments) under statutory, contractual, administrative, or...
The nation's most vulnerable populations rely upon Medicaid and Medicare for essential healthcare services. Regrettably, these programs lose billions of dollars each year as a result of improper payments. Recently, the Subcommittee on Oversight and Investigations explored this pressing issue in an essential hearing titled...
A new audit by the GAO indicates that the government suffered a significant loss of $236 billion in 2023 as a result of improper payments. Medicaid and Medicare alone accounted for 43% of these payments, with Medicaid's improper payments reaching $50.3 billion. These findings highlight...
Medicaid improper payments have caused the safety net program to be on the Government Accountability Office's High-Risk List since 2003. The GAO's list identifies government programs that involve considerable resources and offer vital services to the public that are prone to fraud, waste, abuse, and...
Improper claims payments are costing Medicaid billions. A frequent misunderstanding is that these payments originate from fraud and abuse when the majority stem from prosaic, mundane issues such as eligibility errors and outdated data systems. Take advantage of this opportunity to receive a free quantitative...
According to federal agency data from PaymentAccuracy.gov and the Office of Management and Budget, the federal government spent an estimated $247 billion in improper payments in 2022. The data also uncovered that the Department of Health and Human Services' Medicaid program represented the majority of...
The Government Accountability Office just recently released its updated High-Risk List. The update is part of the biennial High-Risk Series launched in 1990 that identifies government operations vulnerable to fraud, waste, abuse, and mismanagement. The current report marks the twentieth consecutive year that Medicaid has...
Since its passage in 1965, the Medicaid program has expanded to become the single largest payer for health care in the United States, costing $671.2 billion in 2020. Because of spikes in enrollment from the pandemic and the present administration's priorities, spending is only projected...
Dependence on the Medicaid program has increased exponentially over time. Currently, it is the single largest insurer in the United States, and in 2019, it accounted for more than half of all federal funds distributed to states. Regrettably, as the safety net program has grown,...
The federal government doled out almost $100 billion in "improper" Medicaid payments in 2021-- accounting for about one-fifth of all Medicaid payments, according to estimates. The figure represents Washington's current accounting of payments that didn't meet the various requirements for the Medicaid program, which the federal...