The Curious Case of Improper Medicaid Payments
While the Centers for Medicare & Medicaid Services continues its efforts to “crush” Medicaid fraud, a new report says that the biggest source of improper Medicaid payments is… Flawed paperwork. While improper payments generally are categorized as fraud, waste, and abuse, CMS’s focus has been squarely on fraud. At the same time, however, the Congressional Research Service recently reported that flawed paperwork, and not necessarily an attempt to inappropriately or illegally profit from Medicaid payments, is most of the problem. According to the report, CMS estimates that most improper payments (77% in FY2025) are the result of insufficient documentation (e.g., [...]