05:05 GMT +322 January 2019
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    A Medicaid office employee works on reports at Montefiore Medical Center

    US States Losing Billions of Dollars in Bungled Medicaid Payments

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    A report by GAO reveals that US state governments are wasting or losing billions of dollars in bungled payments to hundreds of hospitals.

    WASHINGTON (Sputnik) — US state governments are wasting or losing billions of dollars in bungled payments to hundreds of hospitals, according to a new Government Accountability Office (GAO) report.

    "GAO has found that complete and reliable data are lacking on the tens of billions in Medicaid supplemental payments states often make, hindering transparency and oversight," the report, issued on Tuesday, stated.

    Medicaid is a US government-sponsored social health care program for families and individuals with low income and limited resources.

    Under the Medicaid system, within certain limits, US states can make supplemental payments to providers in addition to their regular claims-based payments and receive federal matching funds.

    However, the GAO pointed out that such payments have grown in the past decade.

    "GAO reported that 39 states made non-DSH supplemental payments to 505 hospitals that, along with regular Medicaid payments, exceeded those hospitals' total costs of providing Medicaid care by about $2.7 billion," the report explained.

    The GAO warned payments that greatly exceed costs raise questions about whether they are economical and efficient as required by law.

    Also, the Centers for Medicare and Medicaid Services (CMS) "lacks data on supplemental payments made to individual providers," the report warned.

    The GAO found that CMS generally does not require or collect data from states on sources of funds to finance Medicaid, nor does it ensure that the data it does collect are accurate and complete.

    It functions as a more than $500 billion dollar jointly-financed program for which the US federal government matches state Medicaid expenditures, the GAO added.

    The US Government Accountability Office is an independent, nonpartisan agency that works for Congress and investigates how the federal government spends taxpayer money.


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    Medicaid, US Government Accountability Office (GAO), United States
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