Payment Prevention is becoming the defining principle of modern Medicaid program integrity. Federal agencies have intensified efforts to combat Medicaid fraud, highlighted by the March 2026 announcement of a new Task Force to Eliminate Fraud. At the same time, Congress

Improper claims payments are costing the Medicaid program billions of dollars every year. A common misconception is that these payments come from fraud and abuse when in reality, the majority stem from prosaic, mundane issues such as eligibility errors and