Medicaid

Medicaid Made $14.4 Billion in Improper Payments Last Year

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Whitehouse.gov

For the Government Accountability Office (GAO) has designated Medicaid, the joint federal-state health program for the poor and disabled, as being a high risk for fraud.

But despite years of attention from the government watchdog, the program continues to waste billions annually on fraud, abuse, and other forms of improper payment.

In the 2013 fiscal year, the agency says in a new report, Medicaid spent about $431.1 billion—about $14.4 billion of which was improperly spent.

That's actually down from the previous year, when the program spent $19.2 billion improperly. But the fact that it's still so high—that's nearly the total amount that Obamacare will likely pay out in subsidies for private insurance this year—mostly serves to reveal how big the problem is.

Of course, Medicaid looks positively thrifty when compared with its bigger sibling, Medicare. The health program for seniors improperly spent $49.9 billion in 2013, a nearly 12 percent increase from 2012.

Even for the government, with its giant budgets and loose attitude toward wasteful spending, this isn't pocket change. And it's likely that similar sorts of payment mistakes will continue under Obamacare, which is already paying insurance subsidies for roughly 2 million people whose applications had inconsistencies. Indeed, the GAO report warns that Obamacare's Medicaid expansion could further complicate the already complex, state-level program integrity efforts for the program. The most straightforward way to shrink fraud and abuse in these giant, complex health programs is to shrink the programs themselves. Instead, we've expanded them, and made more opportunities for improper spending in the process. 

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  1. that’s nearly the total amount that Obamacare will likely pay out in subsidies for private insurance this year

    …debating the sanity of pointing this out on my FB feed.

    1. At least someone got care. Why do you hate the poor and sick, you monster? Also….racist.

  2. Think about how many jobs that $14.4b created. Stimulus, shovel ready, multiplier.

    1. No no no. That money went to already rich doctors, and it is well known that rich people never create jobs with their money. They probably just used it to light their cigars.

  3. If they know which payments were improper, why don’t they get the money back?

    1. They’d need to fill out a bunch of forms.

      1. I always too lazy to fill out the forms for the $10 mail-in rebate when I buy something at Fry’s.

        I can totally see how that scales up to $14.4 billion.

        1. You’d be even less inclined to put any effort into getting a rebate for someone else.

  4. There’s nowhere to cut!

  5. How much of that is intentional fraud? I mean on both ends–people defrauding the government, government officials sneaking money to people they love.

    1. Less than you think. The rules are so complex that it is very difficult to get it right.

      1. I’m sure there’s plenty of that, but where there’s opportunity, there’s fraud.

        My next question is how many people are on disability? And how many of those are actually disabled to the point where they can’t work?

        1. “My next question is how many people are on disability?”

          Almost 11 million at this point.

          “And how many of those are actually disabled to the point where they can’t work?”

          It’s doubled in the last 15 years. So either there’s been a huge spike in disabilities or there are a whole lot of people that wouldn’t have been considered disabled a couple of decades ago currently drawing disability.

          1. Gotta find a way of addicting people to the system and buying votes, right?

    2. I’m assuming that these were not so much fraudulent on the part of the biller, but just bureaucratic snafus that OKd payments where they shouldn’t have been.

    3. Negligence is much more likely than outright malice. On the other side of the coin, it’s probably impossible to determine how much was NOT reimbursed because the doctor simply didn’t file for it.

  6. AKA -Rick Scott’s business plan.

  7. Can anyone explain to me what that first sentence is trying to say?

    1. Ignore the “For.”

    2. Whereas it’s a typo.

    3. Try this:

      For the Government Accountability Office (GAO) hath designated Medicaid, the joint federal-state health program for the poor and disabled, as being a high risk for fraud, and all shall weep.

  8. The most straightforward way to shrink fraud and abuse in these giant, complex health programs is to shrink the programs themselves.

    “Libertarians throw baby out with bath water.”

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