The US Governmental Accountability Office (GAO) reported last month that Medicaid made an estimated $36 billion in payment errors in 2016 due to faulty information.
The case, it said, “[underscores] the need for improved oversight” by the CMS, which relies on state-generated information that payments are proper or that covered services are reaching their intended beneficiaries. But the two information channels CMS uses to determine its expenditures and utilization of services are undermined by “issues with completeness, accuracy, and timeliness,” the report found.
Lyon J. Improper Medicaid Payments. JAMA. 2017;317(10):1009. doi:10.1001/jama.2017.1974
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