Medicaid payment integrity remains a significant challenge as federal oversight continues to focus on reducing improper payments and improving payment accuracy. An August 2026 report from the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG)

Stephen Konsin Jr. from Syrtis Solutions, a solution provider at the Marcus Evans Value-Based Care Summit 2026, discusses the growing need for proactive Medicaid payment accuracy and cost avoidance strategies. Interview with: Stephen Konsin Jr., Vice President of Sales, Syrtis

As states begin planning their fiscal year (FY) 2027 budgets, many Medicaid programs are preparing for tougher financial conditions. State revenue growth has slowed while healthcare spending pressures continue, and recent federal policy changes under the 2025 budget reconciliation law

With the passing of the Trump administration’s spending bill in the House, Medicaid is at the center of the healthcare policy conversation. The program now consumes roughly one-third of most state budgets, placing enormous strain on state finances. Medicaid expansion and pandemic-era

The reported government-wide improper payment rate of 3.97% in 2024 marks the lowest level in over a decade. But beneath the surface lies a complex reality that reveals systemic flaws in how improper payments are calculated and managed. These numbers,

Improper payments and fraud remain persistent and costly challenges 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)

America's most vulnerable populations rely on Medicaid and Medicare for essential healthcare services. Unfortunately, these programs lose billions of dollars annually due to improper payments. Recently, the Subcommittee on Oversight and Investigations delved into this pressing issue in a pivotal

A recent audit by the U.S. Government Accountability Office reveals that the federal government suffered a staggering loss of $236 billion in 2023 due to improper payments. Medicaid and Medicare alone accounted for 43% of these payments, with Medicaid's improper

Medicaid improper payments have caused the healthcare program to be on the Government Accountability Office's High-Risk List since 2003. The GAO's list identifies government-funded programs that involve substantial resources and provide critical services to the public that are vulnerable to

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