August 4, 2015

GAO Says Medicaid’s Size, Complexity Prompt Fraud, Duplication

Medicaid is inherently risky for fraud due to its massive size and bureaucratic complexity – and thanks in part to Obamacar the program is growing quickly, according to the investigative arm of Congress.

Medicaid’s “size and diversity make it vulnerable to improper payments,” the Government Accountability Office reported. These include “payments for treatments or services that were not covered by the program, that were not medically necessary or that were billed for but never provided.”

More than $508 billion was spent on Medicaid in 2014, with an estimated $17.5 billion of that funding improper payments. Expenditures are expected to increase to $529 billion this year.

There were around 72 million participants in 2013 – “roughly one-fifth of the U.S. population,” the report said.

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