Hearing Hearing Date: April 12, 2018 10:00 am 2154 Rayburn HOB

Improper Payments in State-Administered Programs: Medicaid

PURPOSE:

To examine federal and state efforts to identify, prevent, and recover improper payments made through state Medicaid programs.
To examine the federal-state relationship in Medicaid data-sharing, and evaluate fraud identification and prevention in Medicaid programs.

BACKGROUND:

Improper payments have cost taxpayers an estimated $1.2 trillion since 2003. The Department of Health and Human Services (HHS) accounts for two-thirds of all federal improper payments. Medicaid contributes to approximately $36 billion of those improper payments.
The lack of a systemized approach to available data between HHS and state partners has undermined efforts for improved oversight.
Medicaid has appeared on the Government Accountability Office’s (GAO) High Risk List since 2003. The Centers for Medicare & Medicaid Services has worked to implement GAO recommendations to prevent or recover improper payments, but GAO has 34 open priority recommendations dating back to 2002.

Witnesses and testimonies: Tim Hill

Deputy Director, Centers for Medicaid & CHIP Services
U.S. Department of Health and Human Services

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Megan Tinker

Senior Advisor for Legal Review, Office of Counsel, Office of Inspector General
U.S. Department of Health and Human Services

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Carolyn Yocom

Director of Health Care
Government Accountability Office

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The Honorable Daryl Purpera

Legislative Auditor
Louisiana Legislative Auditor

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Andy Schneider

Research Professor of the Practice, Center for Children and Families
Georgetown University

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