Federal Efforts To Combat Medicaid Fraud Inadequate, GAO Finds
Fraud is "widespread" in the Medicaid program, and the federal government's efforts to combat it are inadequate, according to a Government Accountability Office report released Wednesday, the AP/Austin American-Statesman reports. Since 2000, only eight CMS employees have been monitoring state actions against Medicaid fraud, and the report called such oversight "disproportionately small relative to the risk of serious financial loss." GAO officials were unable to estimate total Medicaid fraud, but they "detailed several schemes uncovered by state and federal prosecutors" and suggested that the problem is widespread throughout the system, the AP/American-Statesman reports.
According to Taxpayers Against Fraud Education Fund, the federal government recovered $43 million for Medicaid fraud in 2001, about 20 times less than the $1 billion in recovered Medicare fraud that year. Senate Finance Committee Chair Chuck Grassley (R-Iowa), who requested the GAO study, said the difference in recovered funds can be attributed to more effective government efforts against Medicare fraud. "CMS has a problem with Medicaid fraud, and its limited oversight is insufficient to protect the integrity of the program," Grassley said. CMS Administrator Mark McClellan said his agency is strengthening its financial management staff to review Medicaid spending and is taking steps to combine oversight of Medicaid and Medicare (Sherman, AP/Austin American-Statesman, 8/19).