Medicaid Program Integrity: Increased Oversight Needed to Ensure Integrity of Growing Managed Care Expenditures

In this report released June 19, 2014, the Government Accountability Office (GAO) analyzed state Medicaid program integrity and fraud prevention initiatives. This report examines state and federal roles and responsibilities to identify potential (1) gaps in efforts to ensure Medicaid program integrity coverage; and (2) fragmentation, overlap, or duplication of program integrity efforts, and efforts to coordinate activities. The GAO noted that states spend a greater proportion of efforts on fee-for-service than on Medicaid managed care. Because a majority of states are implementing Medicaid managed care programs, the GAO recommended that states increase their focus on managed care . . .