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Press Release Published: Apr 27, 2023

Chairman Comer, Senator Johnson Renew Request for CMS to Review Improper Payment Rate

WASHINGTON—House Committee on Oversight and Accountability Chairman James Comer (R-Ky.) and Senator Ron Johnson (R-Wis.) sent a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure renewing their request for information on what safeguards CMS has in place to address improper payments in the Medicaid program.

“We write to continue our investigation into the Centers for Medicare and Medicaid Services (CMS) regarding the staggering rate of improper payments in the Medicaid program. As we noted in our April 13, 2022 letter, the reported improper payments rate of 15.62 percent is likely an underestimate. Some estimates show that 27 percent, or more than $100 billion annually, could be improper. This alarming amount threatens the viability of a program designed for Americans in need. We write seeking additional information on what safeguards CMS has in place to address improper payments in the Medicaid program,” the lawmakers wrote.

A year ago, then Ranking Member Comer and Senator Johnson led a bicameral investigation seeking information on the high volume of improper Medicaid payments, yet the improper payment rate continues to increase. This Congress, Chairman Comer and Oversight Republicans have continued the investigation by sending a letter to CMS Administrator Brooks-LaSure requesting information related to reducing improper payments in Medicaid redeterminations after the unwinding of pandemic-era provisions. Chairman Comer also sent a letter requesting the Government Accountability Office (GAO) review actions the CMS can take to coordinate with state auditors and improve Medicaid program integrity.

“As we explained in our April 13, 2022 letter, we are concerned with reports that as much as 95 percent of improper payments were a direct result of eligibility errors. These eligibility errors are exacerbated by inconsistent data collection and retention policies. Some states, like California, abuse the inconsistency, enabling artificially low error rates even though the Department of Health and Human Services (HHS) Inspector General (IG) found that more half of the enrollees in their Medicaid program were ineligible,” the lawmakers continued.

The full text of the letter can be found here.

READ MORE:

Rep. Comer, Sen. Johnson Lead Colleagues in Bicameral CMS Letter on Improper Payment Rate

Comer & Oversight Republicans Press CMS on Medicaid Redeterminations to Reduce Improper Payments

Comer Requests GAO Review Improper Payments in Medicaid Program