The reported government-wide improper payment rate of 3.97% in 2024 represents the lowest level in over a decade. But below the surface lies a complex reality that exposes systemic flaws in how improper payments are measured and controlled. These numbers, far from representing legitimate progress,...
Improper payments and fraud continue to be persistent and costly hurdles 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,...
America's most vulnerable populations depend on Medicaid and Medicare for vital healthcare services. Sadly, these programs lose billions of dollars on a yearly basis due to improper payments. Just recently, the Subcommittee on Oversight and Investigations delved into this pressing issue in a critical hearing...
A recent audit by the U.S. Government Accountability Office reveals 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....
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 significant resources and offer vital services to the public that are vulnerable to fraud, waste, abuse, and...
Improper claims payments are costing Medicaid billions of dollars every year. A frequent misconception is that these payments come from fraud and abuse when the bulk of them actually originate from mundane issues such as eligibility errors and antiquated data systems. Don't miss out on...
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 revealed that the Department of Health and Human Services' Medicaid program accounted for the majority...
The Government Accountability Office just recently released its updated High-Risk List. The update is part of the biennial High-Risk Series started in 1990 that identifies government operations susceptible to fraud, waste, abuse, and mismanagement. The recent report marks the twentieth consecutive year that Medicaid has...
Dependence on the Medicaid program has increased exponentially over time. Presently, it is the single largest insurer in the United States, and in FY 2019, it accounted for over half of all federal monies allocated to states. Regrettably, as the program has grown, waste has...
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...