GAO: Medicaid anti-fraud audit program falls short on cost-benefit analysis

Jun 16 2012

News outlets cover a government report about Medicaid anti-fraud efforts.

The Associated Press/Washington Post: GAO Report: Feds Spent $102M On Medicaid Fraud Contracts, But Only Identified $20M
Private contractors received $102 million to review Medicaid fraud data, yet had only found about $20 million in overpayments since 2008, according to a new report by the federal government. "Significant federal and state resources are being poured in but only limited results are coming out," said Ann Maxwell, a regional inspector general for the U.S. Department of Health and Human Services (6/14).

Los Angeles Times: Costs Exceed Results In Medicaid Fraud Program
An audit program meant to combat Medicaid fraud has cost taxpayers about $102 million since 2008 while identifying less than $20 million in overpayments, according to a report released by the nonpartisan Government Accountability Office on Thursday. The National Medicaid Audit Program used incomplete federal data to conduct 1,550 audits, and apparently because of that, the majority of the audits failed to find any fraud, the GAO said at a Senate hearing (Goldberg, 6/14).

In other fraud news -

Philadelphia Inquirer: Health Care Fraud Investigations Paying Dividends, Justice Department Official Says
Acting Assistant Attorney General Stuart F. Delery told lawyers at the American Bar Association's ninth National Institute on the Civil False Claims Act and Qui Tam Enforcement that health-care prosecutions have worked for taxpayers. "Since January 2009, the Civil Division, working with our partners in the U.S. Attorney offices, has recovered over $11.1 billion under the False Claims Act," Delery told the group last week, according to text of his speech. "Of this amount, more than $7.4 billion was recovered in health care fraud matters, with the largest recoveries coming from the pharmaceutical and medical device industries. These are historic figures" (Sell, 6/14).