Medicare, Medicaid made $100B in improper payments in 2023

The federal government reported an estimated $235.8 billion in improper payments in fiscal year 2023, with more than $100 billion coming from Medicare and Medicaid, according to a March 26 report from the U.S. Government Accountability Office. 

The $235.8 billion in improper payments reported by 14 agencies across 71 programs is a decrease from the $247 billion reported in 2022, but the figure remains higher than pre-pandemic levels, according to the report. 

Of the total improper payments, $175 billion of the errors were overpayments, such as payments to deceased individuals or those longer eligible for the programs, according to the report. Underpayments comprised $11.5 billion of the payment errors, and $44.6 billion were unknown payments, meaning it is unclear whether a payment was an error.  

Medicare payment errors decreased by $30 billion to $51.1 billion in 2023, according to the report. Medicaid payment errors totaled $50.3 billion in 2023.  

The GAO said it has previously made recommendations to help reduce errors and "many of those recommendations still require action from agency leaders." Among those recommendations is that Medicare could improve communication around its prior authorization program, which could reduce expenses and improper payments. The GAO also said Medicaid could improve oversight to ensure claims aren't paid to ineligible providers, such as those who have suspended or revoked medical licenses.

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