United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2001-06-07 monographic deposited born digital 74 p. GA 1.13:GAO-01-662 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-662 P0b002ee1803971e4 f:d01662 DGPO 2010-08-12 2011-03-28 GAOREPORTS-GAO-01-662 machine generated eng fdlp REPORT GAOREPORTS-GAO-01-662 GAO-01-662 Erroneous payments Federal/state relations Fraud Health care programs Health insurance Internal controls Program abuses State-administered programs HCFA Medicaid Fraud and Abuse National Initiative Other Written Product A01032 State Medicaid programs make a wide variety of payments to individuals, institutions, and managed health care plans for services provided to beneficiaries whose eligibility status may fluctuate because of changes in income. Because of the size and the nature of the program, Medicaid is potentially at risk for billions of dollars in improper payments. The exact amount unknown because few states measure the overall accuracy of their payments. Some improper Medicaid payments by states are the result of fraud by billers or program participants, but such improper payments are even harder to measure because of the covert nature of fraud. Efforts by state Medicaid programs to address improper payments are modestly and unevenly funded. Half of the states spend no more than 1/10th of one percent of program expenditures to safeguard program payments. States also differ in how they help prevent improper payments as well as the degree to which they coordinate their investigations and prosecutions of fraud. Federal guidance to the states relies largely on technical assistance. The Health Care Financing Administration has recently taken a more active role to facilitate states' efforts and provide a national forum to share information. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-662/html/GAOREPORTS-GAO-01-662.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-662/pdf/GAOREPORTS-GAO-01-662.pdf GAO-01-662 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-662 Other Written Product GAO-01-662; Medicaid: State Efforts to Control Improper Payments Vary; Erroneous payments Federal/state relations Fraud Health care programs Health insurance Internal controls Program abuses State-administered programs HCFA Medicaid Fraud and Abuse National Initiative Public Law 105-33