The Office of the Inspector General (OIG) found in a report that the Department of Health and Human Services (HHS) did not meet its goals for 2018 to reduce improper payments across its programs, including Medicaid (summary; full report). The impetus to reduce improper payments, and thus reduce federal spending, is in the Improper Payments Information Act (IPIA) and subsequently updated legislation. ANCOR is concerned that the political pressure this will create to save funding will carry policy implications for Medicaid programs, including greater pressure to implement electronic visit verification (EVV), a key issue for ANCOR members.
As shared by OIG:
“[Consulting firm Ernest & Young (EY)] determined that HHS met many requirements but did not fully comply with the IPIA. Among the items required for compliance with the IPIA, EY determined that HHS published the AFR for FY 2018, conducted risk assessments for 22 programs deemed not susceptible to improper payments and determined the programs were not at risk for them, and published corrective action plans for seven of the eight programs OMB deemed susceptible to significant improper payments. EY also determined that HHS published and met annual reduction targets for three of the seven programs for which it reported reduction targets in the FY 2017 AFR and reported an improper payment rate of less than 10 percent for seven of the eight programs OMB deemed susceptible to significant improper payments.
EY concluded that HHS did not comply with several IPIA requirements. EY found that HHS did not report an improper payment estimate for the Temporary Assistance for Needy Families program. EY also determined that HHS did not meet improper-payment-rate reduction targets for Medicaid, the Children's Health Insurance Program, and the Foster Care program and did not conduct recovery audits for the Medicare Advantage program.” [Emphasis added by ANCOR.]