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

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)

Payment integrity programs are designed to ensure accurate claims processing, adherence to contractual rates, and compliance with payment rules. These efforts are vital for maintaining the financial stability of healthcare systems and ensuring that patients receive proper care. However, they