The Department of Energy (DOE) reported that it made about $36 million in improper payments—payments that shouldn’t have been made or were made in the incorrect amount—in FY 2018. But millions more dollars in FY 2018 improper payments could still be found, for example, through audits of contractors that won’t be finished until years later. DOE doesn’t always track information to determi...

Improper payments—those made by the federal government to the wrong person, in the wrong amount, or for the wrong reason—are a significant problem. In fiscal year 2019, government-wide improper payment estimates totaled about $175 billion. The law requires certain agencies to develop and monitor ways to reduce improper payments and take corrective actions to target their root causes. However,...

This report provides an update on the federal government’s fiscal condition at the end of FY 2019 and the unsustainable path it is on if policies don’t change. Among its findings: Publicly held debt rose to 79% of GDP. The Congressional Budget Office and this new report both project it will continue to grow Interest on the debt is the fastest growing item in the budget; it is projected to b...

In fiscal year 2019, agencies across government made an estimated $175 billion in improper payments—payments that should not have been made or were made in the incorrect amount. But this total comes from individual agency estimates, which aren’t all reliable. We also looked at inspectors general reports on agencies’ compliance with a law intended to address improper payments. The law has se...

The Head Start program helps children from low-income families get ready to attend school. We attempted to enroll fictitious children in 15 Head Start centers using information that should have disqualified our applications, such as pay stubs that exceeded income requirements. We found: Potential fraud at 5 centers. For example, in 3 cases, we retrieved our applications and found they had been do...

Medicare and Medicaid review medical record documentation to ensure that they're only paying eligible doctors and hospitals for medically necessary, covered services. These reviews found an estimated $27.5 billion in payment errors due to insufficient documentation in FY 2017. We found that Medicare and Medicaid have different documentation requirements for some of the same services, contributing...

The Improper Payments Information Act of 2002, as amended (IPIA), defines “significant” improper payments as improper payments in the preceding fiscal year that may have exceeded either (1) 1.5 percent of program outlays and $10 million or (2) $100 million (regardless of the improper payment rate). GAO found that the Departments of Health and Human Services (HHS), the Treasury (Treasury), Just...

Over half of the 24 Chief Financial Officers Act of 1990 (CFO Act) agencies were reported by their inspectors general (IG) as noncompliant with one or more criteria under the Improper Payments Elimination and Recovery Act of 2010 (IPERA) for fiscal years 2016 and 2017. Nine CFO Act agencies have been reported as noncompliant in one or more programs every year since the implementation of IPERA in f...

The six agencies GAO reviewed reported taking various approaches related to key components of estimating improper payments—shown in the figure below—for 10 selected programs, which collectively reported outlays of over $2.5 trillion for fiscal year 2017.Key Components in the Development of Improper Payment EstimatesSample selection. Eight of the 10 programs GAO reviewed reported using statist...

GAO's review of the 24 Chief Financial Officers Act of 1990 (CFO Act) agencies' fiscal years 2014 through 2016 agency financial reports (AFR) and performance and accountability reports (PAR) found that these agencies generally adhered to the Office of Management and Budget's (OMB) improper payment risk assessment reporting directives. However, GAO found instances of nonadherence, including the fol...

In fiscal year 2016, the Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS) assessed its advance premium tax credit (PTC) program as susceptible to significant improper payments. CMS instituted a qualitative method for assessing the susceptibility of its program that was consistent with requirements, including assessing each of the nine required qualitati...

Five years after the implementation of the Improper Payments Elimination and Recovery Act of 2010 (IPERA), 15 of the 24 Chief Financial Officers Act of 1990 (CFO Act) agencies were reported by their inspectors general (IG) as noncompliant under IPERA for fiscal year 2015. The programs associated with these 15 agencies accounted for $132 billion (or about 96 percent) of the reported $136.7 billion...

The Department of Agriculture's National School Lunch Program and School Breakfast Program give schools billions of dollars every year to provide meals for children. Historically, the rates of estimated payment errors have been high, suggesting that the programs may be vulnerable to fraud. USDA has reported taking steps to reduce these errors. However, we found that USDA doesn't regularly assess...

The U.S. government allocated about $30 billion for child nutrition programs in FY 2018, including about $14 billion for the school lunch program. USDA oversees the programs. States contract with schools and others to provide the services. In prior work, we have recommended ways USDA can improve its oversight of the programs. This testimony discusses steps USDA has taken, or is planning to take,...

The Medicaid program helped provide health care to an estimated 73 million people in fiscal 2017 at a cost of about $596 billion. This joint federal and state program continues to grow, and remains on our high risk list due to concerns about the adequacy of federal oversight and the program's vulnerability to fraud. This testimony focuses on the major risks to the integrity of Medicaid. Efforts n...

Department of Labor (DOL) data show that some states have formal warning policies that allow Unemployment Insurance (UI) claimants to receive benefits after the first discovered occurrence of their failing to meet work search requirements while most states do not have such policies. As a result, states are inconsistent in whether they report such benefit payments as overpayments, which has an impa...

The Centers for Medicare & Medicaid Services estimates that about $16 billion or nearly 10% of its payments to Medicare Advantage organizations were improper. In this testimony, we reviewed several problems we have found with CMS's efforts to ensure proper payments in this program that serves about a third of Medicare beneficiaries. For example, certain CMS audits do not target Medicare Advantag...

Improper payments, which generally include payments that should not have been made, were made in the incorrect amount, or were not supported by sufficient documentation, remain a significant and pervasive government-wide issue. Since fiscal year 2003—when certain agencies began reporting improper payments as required by the Improper Payments Information Act of 2002—cumulative improper payment...

What the Participants SaidDuring the GAO-sponsored forum, panelists discussed the following topics related to analytics to address improper payments, including fraud: ► Opportunities for Collaboration Collaboration between the government, private sector, public–private partnerships, and academia may allow entities to share analytics-related resources and knowledge to address the challenge o...

DOE's inadequate management and oversight of its contractors led us to designate its contract management as a High Risk area. For example, in November 2016, DOE contractors constructing a nuclear waste treatment plant agreed to pay a combined $125 million to settle a lawsuit alleging, among other things, that a contractor improperly used federal funds for lobbying purposes. We found that DOE does...

Medicaid is a joint federal-state health care program for low income and medically needy people, with an estimated $36 billion in improper payments in fiscal year 2016. We've identified some ways to reduce these errors, such as by confirming that Medicaid's participants and health care providers meet eligibility requirements, effectively overseeing managed care organizations, and ensuring that pa...

The Office of Management and Budget (OMB), in coordination with the Department of the Treasury (Treasury), developed the Do Not Pay (DNP) working system as a data matching service for agencies to use in preventing improper payments, but GAO found that the DNP working system offers either partial or no access to three of the six databases required by the Improper Payments Elimination and Recovery I...