AbdulQadir7
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In 2024 the U.S. government made $149 billion in improper payments enough to fund NASA for seven years or build 15 aircraft carriers. Medicare and Medicaid accounted for over $60 billion of this amount followed by tax credits (over $20 billion) and food assistance (over $10 billion). These figures point to a systemic issue within government oversight.
Improper payments are defined as payments that did not meet the Centers for Medicare & Medicaid Services (CMS) program requirements and can be overpayments underpayments or payments made with insufficient information to determine whether the payment was proper. CMS clarifies that these estimates are not fraud rate estimates though fraud can be a factor. A large portion of the improper payments is due to insufficient documentation.
The Payment Integrity Information Act of 2019 defines significant improper payments as those exceeding $10 million and 1.5% of all payments made under a program or those exceeding $100 million.
Despite $33.5 billion being identified as potentially recoverable in 2024 agencies only managed to recover $22.6 billion leaving the rest unrecovered due to bureaucratic issues. While some believe that the Department on Government Efficiency (DOGE) is overreaching in its targeting of agencies like USAID the data indicates that waste is pervasive across many of the largest government programs.
For 2024, specific improper payment rates for CMS programs include:
• Medicare Fee-for-Service (FFS): 7.66%, or $31.70 billion.
• Medicare Part C: 5.61%, or $19.07 billion.
• Medicare Part D: 3.70%, or $3.58 billion.
• Medicaid: 5.09%, or $31.10 billion.
• Children’s Health Insurance Program (CHIP): 6.11%, or $1.07 billion.
• Advance Payments of the Premium Tax Credit (APTC) program for the Federally-facilitated Exchange (FFE): 1.01%, or $562.93 million.
Improper payments are defined as payments that did not meet the Centers for Medicare & Medicaid Services (CMS) program requirements and can be overpayments underpayments or payments made with insufficient information to determine whether the payment was proper. CMS clarifies that these estimates are not fraud rate estimates though fraud can be a factor. A large portion of the improper payments is due to insufficient documentation.
The Payment Integrity Information Act of 2019 defines significant improper payments as those exceeding $10 million and 1.5% of all payments made under a program or those exceeding $100 million.
Despite $33.5 billion being identified as potentially recoverable in 2024 agencies only managed to recover $22.6 billion leaving the rest unrecovered due to bureaucratic issues. While some believe that the Department on Government Efficiency (DOGE) is overreaching in its targeting of agencies like USAID the data indicates that waste is pervasive across many of the largest government programs.
For 2024, specific improper payment rates for CMS programs include:
• Medicare Fee-for-Service (FFS): 7.66%, or $31.70 billion.
• Medicare Part C: 5.61%, or $19.07 billion.
• Medicare Part D: 3.70%, or $3.58 billion.
• Medicaid: 5.09%, or $31.10 billion.
• Children’s Health Insurance Program (CHIP): 6.11%, or $1.07 billion.
• Advance Payments of the Premium Tax Credit (APTC) program for the Federally-facilitated Exchange (FFE): 1.01%, or $562.93 million.