This testimony by Gene L. Dodaro, Comptroller General of the United States, focuses “on the (1) major risks to the integrity of the Medicaid program, and examples of actions CMS has taken to address these risks; and (2) other actions needed to strengthen oversight of the program. This testimony draws on GAO’s reports issued between November 2012 and July 2018 on the Medicaid program, and information on a program integrity strategy CMS announced in June 2018.”
“As reported in GAO’s June 2018 testimony, GAO’s prior work has also identified the following fundamental actions needed to strengthen oversight.
- Improve data. CMS’s Transformed Medicaid Statistical Information System initiative has the potential to improve program oversight, but more needs to be done to collect complete and comparable data from all states. • Implement a fraud-risk strategy. CMS established the Center for Program Integrity to lead antifraud efforts and has required antifraud training for stakeholders. However, CMS still needs to conduct a fraud risk assessment and implement a risk-based antifraud strategy for Medicaid.
- Increased collaboration between the federal government and the states can help reduce improper payments. State auditors are uniquely qualified to partner with CMS in its oversight of Medicaid. CMS could help improve program integrity by providing state auditors with a substantive and ongoing role in auditing state Medicaid programs…” Read the full testimony here.
Source: CMS Has Taken Steps to Address Program Risks but Further Actions Needed to Strengthen Program Integrity – August 21, 2018. GAO.gov.
