Ethan Barton of the Daily Caller reports on the Affordable Care Act’s impact in boosting the likelihood of Medicaid fraud.
Medicaid is inherently risky for fraud due to its massive size and bureaucratic complexity – and thanks in part to Obamacar the program is growing quickly, according to the investigative arm of Congress.
Medicaid’s “size and diversity make it vulnerable to improper payments,” the Government Accountability Office reported. These include “payments for treatments or services that were not covered by the program, that were not medically necessary or that were billed for but never provided.”
More than $508 billion was spent on Medicaid in 2014, with an estimated $17.5 billion of that funding improper payments. Expenditures are expected to increase to $529 billion this year.
There were around 72 million participants in 2013 – “roughly one-fifth of the U.S. population,” the report said.
“In 2003, GAO designated Medicaid as a high-risk program due to its size, growth, diversity of programs and concerns about gaps in oversight – and more than a decade later, those factors remain,” the report said.
“The bottom line is that this is a critical program for low-income individuals,” said the report’s co-author, GAO Health Care Director Carolyn Yocom, in a podcast released in connection with the report.
“However, it is also a big part of federal and state budgets, and we have a responsibility to ensure that the money goes to where it’s most needed. We need better data and better information in order to accomplish that,” Yocom said.
Barton’s reporting offers another reason to question the wisdom of Medicaid expansion.
