Medicaid Fraud Program a Bust

A recent report from the Government Accountability Office (GAO) showed that the National Medicaid Audit Program cost taxpayers about $102 million since 2008, but realized under $20 million in overpayments. The report says that audits only identified overpayments 4 percent of the time. Peter Budetti, Deputy Administrator for the Centers for Medicare & Medicaid Services (CMS) says that CMS plans to redesign the program and has stopped conducting audits based on data in its federal Medicaid database that did not include names of hospitals or doctors and other essential information in detecting fraud. The National Medicaid Audit Program is expected to use state and federal data in a collaborative approach to identify areas of potential fraud, and the new approach used in 32 audits found more than $12 million in possible overpayments.


Contact ABISA, a consultancy specializing in solo and small group practice management. Visit us at

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s