The US Department of Health and Human Services did not adequately ensure that Medicaid demonstration projects in Florida and Vermont, intended to explore new ways to deliver and pay for health care (such as through managed care), were budget neutral as required by federal law, according to the Government Accountability Office (GAO). As a result, the GAO estimated that Medicaid spent an excess $6.9 billion in Florida and $246 million more in Vermont for the 5-year demonstration projects.
Mitka M. Demonstration Projects. JAMA. 2008;299(14):1657. doi:10.1001/jama.299.14.1657-d