"Certainly the legalized money laundering from state-directed payments and provider taxes, no matter what you might think about them, don't align with the federal government and with state governments. They do quite the opposite. It was a grab bag, and states could take as much as they could from the federal government. Oftentimes, states were different in their capabilities, so some states took a lot, and others didn't."
"We're actually chasing the money now, not the person. And we have joined initiatives with the Treasury and DOJ to address some of these issues that you'll be hearing more about. We have already stopped about $4 billion from leaving the building by using these kinds of tactics."
Medicaid has become the fastest-growing expense for most states, often crowding out funding for education and social services. Federal Medicaid spending increased by about 50% over five years, with much of the growth tied to pandemic-era policies that were not rolled back. Many states levy provider taxes and use state-directed payments to trigger additional federal Medicaid matching funds, creating incentives to maximize federal draws. CMS is shifting enforcement to follow the flow of money and has partnered with the Treasury and DOJ to stop improper outflows, reporting roughly $4 billion prevented from leaving the system. Fraud in Medicaid and Medicare remains abundant.
Read at MedCity News
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