A growing number of state Medicaid programs are utilizing managed care organizations (MCOs) to deliver healthcare services to beneficiaries. According to a new report from the Government Accountability Office (GAO), however, gaps in oversight may have caused Medicaid programs to wrongly pay out more than $14 billion last year to MCOs for treatments or services that were unnecessary, never performed, or ineligible for coverage. The GAO emphasized the need to improve oversight of MCOs and increase cooperation between state and federal program integrity units. In 2013 alone, Medicaid covered almost 72 million Americans, and the program costs American taxpayers more than $430 billion annually. The GAO predicted that, unless state and federal governments enhance oversight over MCOs, the amount of improper payments could increase.

Read the entire article, “Here’s where $14 billion of taxpayer money for Medicaid went”
Read the GAO report, “MEDICAID PROGRAM INTEGRITY: Increased Oversight Needed to Ensure Integrity of Growing Managed Care Expenditures”