GAO Tag

Medicaid High Risk List GAO Syrtis Solutions Program Integrity Oversight Improper Payments Cost Avoidance

29 Jun MEDICAID ADMINISTRATIVE CHALLENGES

Medicaid has been designated as a high-risk government program by the GAO since 2003. The Medicaid program has struggled over the past seventeen years due to poor fiscal oversight and other administrative issues. These challenges will be exasperated as the program expands and enrollment surges...

Read More
GAO Medicaid Improper Payments Fiscal Oversight Syrtis Solutions

24 Jun MEDICAID IMPROPER PAYMENTS IN 2019

Improper payments in the Medicaid universe are payments full or partial claims payments paid in error or payments made to the wrong party. Improper payments have been a major problem for Medicaid in recent years and have cost the program's valuable resources.  Across all government programs, improper payments have...

Read More

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...

Read More

23 Jul MEDICAID COSTS PUT EMPHASIS ON RECOVERY EFFORTS

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,...

Read More

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...

Read More

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...

Read More