Medicaid Audit Cost Five Times More Than It Recovered

A federal program to fight Medicaid fraud has cost the U.S. at least $102 million in auditing fees while identifying less than $20 million in overpayments, General Accountability Office investigators have found. The majority of the audits conducted by 10 contractors were discontinued, produced low or no findings, or were put on hold. More than two-thirds of 1,550 audits of state records since fiscal year 2008 identified $7.4 million in possible Medicaid overpayments.

Audits of state Medicaid records were stopped in February 2011. The federal Centers for Medicare and Medicaid Services has reportedly reassigned the auditors to work collaboratively. This arrangement requires state Medicaid officials to identify health providers or industries they think federal auditors should target.

There are reportedly 137 collaborative audits underway.