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House Energy and Commerce Leaders Demand Accountability in Medicaid

House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA), Subcommittee on Health Chair Brett Guthrie (R-KY), and Subcommittee on Oversight & Investigations Chair Morgan Griffith (R-VA) showed strong leadership on an issue that deserves national attention: runaway spending and improper payments in Medicaid.

In a startling letter to Medicaid’s program administrator at the Centers for Medicare & Medicaid Services (CMS), these members of Congress urged CMS to take immediate action to address and rectify some truly concerning recent findings.

The members reminded the administrator of a 2022 audit from the inspector general of the Department of Health and Human Services, which found that “significant Medicaid payments were made on behalf of deceased enrollees,” as well as to “ineligible beneficiaries” and “providers who should not be practicing in the program.”

The cost of these failures is stunning. From the letter:

“Improper payments are widespread in Medicaid and have been estimated at $359.39 billion over the past five years. Such payments represent a significant misuse of funds that redirects payments away from providing essential care to our nation’s most vulnerable populations.” 

Improper payments are not just limited to those made to potentially ineligible beneficiaries but also include payments to providers who should not be practicing in the program.

When law-abiding taxpayers are forced to cover the bill for fraud and improper payments, that’s unacceptable. Especially with more than 100 million Americans now on Medicaid, a milestone surpassed earlier this year.

The members also reminded the program administrator that:

“The Government Accountability Office (GAO) designated Medicaid as a high-risk program in 2003. As of February 2023, 70 GAO recommendations related to the Medicaid program remain open.”

The Biden administration owes the American people a response, and the Energy and Commerce Committee leaders should be applauded for their efforts in bringing this massive failure to light.

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