Many states avoid paying their share of Medicaid expenses, an issue the U.S. Department of Health and Human Services has known about for more than a decade, according to the Washington Post. Pennsylvania, for instance, taxed healthcare providers and then used this revenue to give the providers higher reimbursements. North Carolina used a similar tactic and added $60 million to its coffers. Since such findings, the Centers for Medicare & Medicaid Services, along with Congress, now cap Medicaid payments for healthcare providers--such policies have helped save $79 billion in 10 years. Article