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GAO Calls for Increased Oversight of Payments and Program Integrity

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GAO Calls for Increased Oversight of Payments and Program Integrity

April 26, 2012

On April 25, the Government Accountability Office (GAO) released written testimony by Carolyn Yocom, director of health care, discussing federal oversight of payments and Medicaid program integrity.


In 2010, GAO reported that the Centers for Medicare & Medicaid Services (CMS) was not adequate in ensuring that all states were in compliance with various actuarial requirements which sought to manage costs and reduce misspent funds. In December 2011, the GAO testified that CMS key oversight challenge was ensuring effective coordination to avoid duplicating state program integrity efforts.


GAO found that CMS has taken, since the 2010 report, a number of steps to address variations that contributed to inconsistent oversight, but that further action is required. The testimony notes that certain recommendations made by GAO have not been implemented by CMS, such as transparency requirements for non-disproportionate share hospital payments.


Yocom noted that the Medicaid Integrity Institute, established in 2007, appears to improve state coordination and collaboration. Yocom also noted that GAO's work in these areas is ongoing and that it will continue to review CMS Medicaid program integrity activities.