Waste, Fraud, and Abuse in Medicare and Medicaid Still Await Solutions

Kathryn Nix /

Recent hearings in both the House Energy and Commerce Subcommittee on Oversight and Investigation and the Senate Finance Committee took a closer look at fraud within Medicare and Medicaid.

Spending on Medicare and Medicaid is on an unsustainable path due to rising health care costs and an aging population. Meanwhile, fraud within the program contributes to the program’s cost by an estimated $60 billion a year. Medicaid, the federal–state partnership to provide health care to the poor and disabled, is a victim of abuse as well.

Reducing health care costs and improving quality are priorities for health care reform. Tackling fraud within Medicare and Medicaid would not solve their long-term insolvencies but is an obvious place to find savings. Unfortunately, Washington has a long way to go to make it happen. A recent report from the Government Office of Accountability (GAO) highlights Medicare as a “high-risk” system because of its complexity, size, and “susceptibility to improper payments.” (more…)