Medicaid managers have done little to stem rampant fraud in the massive government health care program for the poor, which totaled more than $29 billion last year, according to a new Government Accountability Office (GAO) report to Congress.
As Medicaid gradually transforms from a traditional fee-for-service operation to managed care, the challenge for federal and state Medicaid officials to weed out fraudulent applicants or health care providers has become increasingly difficult.
Yet the Centers for Medicare and Medicaid Services (CMS), which oversees the program, along with state Medicaid officials, have yet to streamline or better coordinate the databases that are essential in ferreting out fraud, according to the new report.
The Medicaid program finances health care coverage for an estimated 69 million beneficiaries with estimated expenditures of $529 billion in fiscal 2015 alone. CMS previously revealed that improper Medicaid payments totaled $29.12 billion in fiscal 2015, or 9.78 percent of total Medicaid expenditures. That was up from $14.4 billion or 5.8 percent of the total in fiscal 2013.
Both Medicaid and Medicare, the premier federal programs to assist low-income Americans and the elderly, have been beset
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