GAO Report Finds Agency Ineffective in Medicaid Oversight

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WESLACO - A government watchdog group said the agency that oversees Medicaid is not running the program like they should.

The Government Accountability Office said Medicaid improperly paid out about $36 billion in the 2016 fiscal year.

More than 70 million people in the U.S. depend on Medicaid, a service paid for by taxpayers. It’s one of the largest payers for healthcare in the U.S.

The Centers for Medicare & Medicaid Services, agency under the Department of Health and Human Services, is in charge of Medicaid.

The GAO said money trickles down from the federal government to the states. The idea is that states hand out those funds to people and agencies that need it the most.

Carolyn Yocom with the GAO said that’s not happening in its entirety. She said the problem lies with states not doing a good job of keeping track of the money.

Yocom said it’s hard for the federal government to know when states are paying the right people for the right services.

“The other danger in a program integrity environment is providers can move,” she said. “So, they can get identified in one state, and if they are a bad actor, then move to the next state.”

Yocom said states often run behind in letting the federal government know information about providers. She said the delay opens the door to potential cases of fraud.

The GAO said DHHS needs to make some changes. They said there needs to be more program oversight, as well as quicker access to information about who’s getting the money and how it’s being spent.

The agency in charge of Medicaid agreed and said it’s working to fix it. 

Link: Program Oversight Hampered by Data Challenges, Underscoring Need for Continued Improvements


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