A new report finds that the federal government made nearly $236 billion in improper payments across entitlement programs last year, with Medicare and Medicaid a large source of payment errors.
The Government Accountability Office's analysis found that about $186 million of the payments noted in 2023 were concentrated in five key programs: Medicare, Medicaid, Pandemic Unemployment Assistance, the Earned Income Tax Credit and Paycheck Protection Program loan forgiveness.
Medicare was the largest individual program, accounting for $51.1 billion in improper payments, or 22% of the total. Medicaid was close behind at 21%, or $50.3 billion.
Improper payments can include inaccurate recordkeeping, overpayments or fraud, according to the report.
"Payment errors are a long-standing issue for the federal government," the GAO wrote in a blog post. "Over the last 20 fiscal years, it has made an estimated $2.7 trillion in such improper payments."
While the total number of improper payment remains high, the report did find that the figure is on the decline. Improper payments hit a record high in 2021 at $281.4 billion and decreased to $247 billion in 2022.
The GAO also offered key recommendations to both regulators and legislators that could help address the broader issue around improper payments. Broadly speaking, the report suggests federal agencies can do more to monitor these programs and plan ahead for potential risks.
They'll need support in that initiative, however, and that's where Congress can play a role. Legislators can assist in building ways to estimate errors and take corrective action.
The report also offers solutions for the programs that make up the lion's share of improper payments. GAO recommends that Medicare take steps to improve communication around prior authorization, as that could reduce expenses and improper payouts.
In Medicaid, states should boost oversight to make sure that payments are going to eligible providers.