Under the Payment Integrity Information Act of 2019, the Centers for Medicare & Medicaid Services (CMS) was required to review federal programs at risk of improper payments. The bill tasked CMS to assess what programs are at risk, estimate the number of improper payments, and report...
Dependence on the Medicaid program has increased exponentially over time. Currently, it is the single largest insurer in the United States, and in FY 2019, it accounted for more than half of all federal funds distributed to states. Unfortunately, as the safety net program has...
Improper payments cost Medicaid $86.49 billion in 2020 alone. A common misconception is that improper payments come from fraud and abuse when in reality the majority come from prosaic, ordinary problems such as eligibility errors and antiquated data systems. Fraud in Medicaid may well still...
Improper payments, fraud, and waste cost the Medicaid program billions of dollars every year. In 2020 alone, Medicaid improper payments reached $86.49 billion. These payments account for more than twenty percent of federal Medicaid expenditures, and one out of every four Medicaid dollars is spent...
Medicaid is the single largest payer of health care in the United States. As the program has grown in size and scope, it has struggled with fraud, waste, abuse, and improper payments. Over the years, there have been a number of federal initiatives to rein...
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...
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...
Over the past ten years, Medicaid has become one of the fastest and largest growing items on state budgets. In 2015, the program accounted for 20 percent of state budget spending and in 2018 it had grown to 30 percent. Last month, a report from...
Since Medicaid’s inception in 1965, the program has expanded to become the largest provider of healthcare coverage in the country. As the member population size has grown, Medicaid third party liability (TPL) efforts and fiscal responsibility have been reoccurring issues. To protect Medicaid’s solvency, there...
DHHS has released its annual Agency Financial Report for FY 2018. The report provides an overview of improper payments in the Medicaid program, root causes for the payments, and corrective actions. In line with the agency's goal of reforming, strengthening, and modernizing the nation’s healthcare...