GAO: Medicaid Program Integrity: Improved Guidance Needed to Better Support Efforts to Screen Managed Care Providers

GAO found that the selected states and Medicaid managed care plans face significant challenges in screening providers for eligibility to participate in the Medicaid program. GAO examined approximately 881,000 Medicaid providers in four states and found that in fiscal year 2011 hundreds of these providers were potentially receiving improper Medicaid payments. The providers had suspended or revoked medical licenses, had invalid addresses, were identified as deceased in federal death files, or had been excluded from federal health care programs, including Medicaid.