The U.S. Government Accountability Office released more reports last month on the perpetual problem of government payment errors, this time within the Medicaid program, and the results were depressing.
The mammoth program, which covers 70 million people, had a budget of $576 billion last year, and made $346 billion in total payments. Unfortunately, $36.3 billion of those payments were improper — an error rate of 10.5 percent.
“We and others have expressed long-standing concerns about the completeness, accuracy and timeliness of available Medicaid data, and the effect of these inefficiencies on (the Centers for Medicare and Medicaid Services’) ability to ensure the fiscal integrity of the program,” the GAO scolded. “ As a steward of the program, CMS must take immediate steps to ensure the appropriate use of scarce federal and state dollars.”
Or else what? It is extremely unlikely that any heads are going to roll for such ongoing mismanagement.
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President Donald Trump and House Republicans have suggested converting Medicaid to a block grant to states. Though block grants are not a panacea, and large states would still struggle with payment errors, devolving power to the states could help reduce waste and fraud, while eliminating a layer of bureaucracy and offering the states more flexibility. Given Medicaid’s record, the program is long overdue for a shake-up.