Medicaid still leads gov in payment errors but showing improvement
The latest Government Accountability Office (GAO) report on government payment errors finds some progress post-pandemic, but still tallies more than $50 billion in improper payments each for HHS’ Medicare and Medicaid programs in fiscal year 2023.
Across all 14 agencies and 71 programs examined in the report, the improper payment total was pegged at $236 million, about $11 billion less than the prior year. In general, however, recent improvements have not brought improper payment estimates to pre-2020 levels.
“Improper payments—those that should not have been made or were made in the incorrect amount—have consistently been a government-wide issue,” the GAO says in a March 26 report. “Since fiscal year 2003, cumulative improper payment estimates by executive branch agencies have totaled about $2.7 trillion. Reducing improper payments is critical to safeguarding federal funds.”
Medicaid’s $50 billion in improper payments was the highest total for a single program. Medicare was tracked as three programs, with Fee-for-Service improper payments totaling $31 billion and Medicare Advantage errors an estimated $17 billion. Medicare Prescription Drug benefit had $3 billion in errors.
While Medicaid had the highest total, it was also the most improved program, cutting about $30 billion from its 2022 improper payments total. The GAO report attributed the improvement to better state compliance and the return of more stringent payment reviews as Covid-19 flexibilities continued to phase out.
The GAO referred to previous suggestions it had given to further reduce improper payments. It said Medicare should improve prior authorization communication, while Medicaid can improve oversight to ensure claims are not paid to ineligible providers.
Evan joined TriMed in 2011, writing primarily for Health Imaging. Prior to diving into medical journalism, Evan worked for the Nine Network of Public Media in St. Louis. He also has worked in public relations and education. Evan studied journalism at the University of Missouri, with an emphasis on broadcast media.