Improper Payments in State-Administered Programs: Medicaid

Subcommittee on Government Operations
Subcommittee on Government Operations
Subcommittee on Intergovernmental Affairs
Subcommittee on Intergovernmental Affairs
Hearing Date: April 12, 2018 10:00 am 2154 Rayburn HOB

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

Name Title Organization Panel Document
Tim Hill Deputy Director, Centers for Medicaid & CHIP Services U.S. Department of Health and Human Services Document
Megan Tinker Senior Advisor for Legal Review, Office of Counsel, Office of Inspector General U.S. Department of Health and Human Services Document
Carolyn Yocom Director of Health Care Government Accountability Office Document
The Honorable Daryl Purpera Legislative Auditor Louisiana Legislative Auditor Document
Andy Schneider Research Professor of the Practice, Center for Children and Families Georgetown University Document