The Centers for Medicare & Medicaid Services reviews states’ efforts to reduce improper Medicaid payments, and encourages them to use collaborative audits—where CMS contractors and states work together to review the accuracy of payments made. Collaborative audits have identified substantial potential overpayments to providers, but barriers have limited their use. CMS encourages states to use collaborative audits, but states decide whether to pursue them. Several states reported positive collaborative audit experiences, while others cited barriers—such as staff burden or problems communicating with contractors—that prevented them from seeking audits or hindered the success of audits.
GAO also found that CMS lacks a systematic approach to collecting and communicating information about state practices to reduce Medicaid improper payments.Read the full report