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 2002-02-28 monographic deposited born digital 49 p. GA 1.13:GAO-02-300 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-02-300 P0b002ee18037fa91 f:d02300 DGPO 2010-08-12 2011-03-24 GAOREPORTS-GAO-02-300 machine generated eng fdlp REPORT GAOREPORTS-GAO-02-300 GAO-02-300 Erroneous payments Financial management Health care costs Internal controls Reporting requirements Risk management Medicaid Program State Children's Health Insurance Program Other Written Product A02818 The Medicaid program spent more than $200 billion in fiscal year 2000 to meet the health care needs of nearly 34 million poor, elderly, blind, and disabled persons. States are responsible for making proper payments to Medicaid providers, recovering misspent funds, and accurately reporting costs for federal reimbursement. At the federal level, the Centers for Medicare and Medicaid Services (CMS) oversee state financial activities and ensure the propriety of expenditures reported for federal reimbursement. GAO found that weak financial oversight by CMS leaves the program vulnerable to improper payments. The Comptroller General's Standards for Internal Control in the Federal Government requires that agency managers perform risk assessment, take steps to mitigate identified risks, and monitor the effectiveness of those actions. The standards also require that authority and responsibility for internal controls be clearly defined. CMS oversight had weaknesses in each of these areas. As a result, CMS did not know if its control efforts were focused on areas of greatest risk. CMS also was not effectively implementing the controls it had in place. Furthermore, managers had not established performance standards for financial oversight activities, particularly their expenditure review activity. Limited data were collected to assess regional financial analyst performance in overseeing state internal controls and expenditures. In addition, the CMS audit resolution procedures did not collect enough information on the status of audit findings or ensure that audit findings were resolved promptly. CMS' current organizational structure lacks clear lines of authority and responsibility between the regions and headquarters. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-02-300/html/GAOREPORTS-GAO-02-300.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-02-300/pdf/GAOREPORTS-GAO-02-300.pdf GAO-02-300 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-02-300 Other Written Product GAO-02-300; Medicaid Financial Management: Better Oversight of State Claims for Federal Reimbursement Needed; Erroneous payments Financial management Health care costs Internal controls Reporting requirements Risk management Medicaid Program State Children's Health Insurance Program Title 42 Part 430.30 42 CFR Part 430.30 Title 42 Part 430.30 42 CFR Part 430.30