Medicaid Third Party Liability GAO CMS Syrtis Solutions ProTPL TPL OHI

20 Sep Medicaid Third Party Liability Report From GAO

Identifying third party liability continues to be a challenge under the coordination of benefits for Medicaid plans. By law, plans are payers of last resort so whenever beneficiaries have other active coverage (OHI), those third parties should pay first. Currently, Medicaid plans are required to...

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Medicaid cost avoidance


In 1965, Title XIX of the Social Security Act established the Medicaid program to provide health care coverage to low-income individuals. Over time it has developed into one of the nation's largest payers for health care, covering one out of five Americans. In FY 2017,...

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Medicaid Spending Integrity Reform Technology Solutions Syrtis Solutions

08 Dec GAO Reports $95 Billion Wasted in Fiscal 2016

The GAO reported this week that The Centers for Medicare & Medicaid Services must create a much more robust risk-based anti-fraud strategy for the Medicare and Medicaid programs. Improper payments within both programs amounted to about $95 billion in fiscal 2016. The Government Accountability Office, in...

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14 Feb $36 Billion in Improper Medicaid Payments in 2016

For the fourth straight year, the federal government increased the amount of money described as improper payments. The Government Accountability Office is reporting that agencies exceeded $144 billion in improper payments in fiscal 2016, up from $137 billion in 2015. This increase translates to a higher...

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