Naples, FL – New research released today by the Foundation for Government Accountability (FGA) finds that program eligibility errors account for most improper spending in the Medicaid program—which reached $60 billion in 2017—and underscores the need for executive action to restore Medicaid integrity and preserve resources for the truly needy.
More than 10 percent of total Medicaid spending is considered improper, with the majority of that spent on individuals who do not qualify for Medicaid. Obama-era regulations made it more difficult for states to combat fraud by stifling their flexibility to recheck eligibility, leading to increases in improper spending.
Earlier this year, President Trump signed an executive order directing federal officials to increase Medicaid program integrity and preserve resources for the truly needy. By repealing regulations adopted under the Obama administration, the Trump administration can fulfill that promise and return the Medicaid program to its original intent.
“Research shows that beneficiaries cannot be counted on to report changes in their own eligibility. Every dollar spent on someone who does not qualify is a dollar that can’t be spent on someone who is truly in need,” said Victoria Eardley, FGA research fellow and co-author of the memo. “The administration should act quickly to restore states’ ability to verify Medicaid eligibility to ensure program integrity and prioritize funding for those most in need.”
The full memo can be found here.
The Foundation for Government Accountability is a non–profit, multi–state think tank that specializes in health care, welfare, and work reform. To learn more, visit TheFGA.org.