Audit Topic

Program Integrity

Medicaid audit reports involving fraud prevention, improper payments, recoveries, compliance controls, and program integrity operations.

US
2025
Featured

Ohio Medicaid Managed Care Medical Loss Ratio Audit

Centers for Medicare & Medicaid Services, Center for Program Integrity
Published 2025

While no remittances were required based on the findings, the audit identified multiple areas for improvement in Ohio’s oversight and reporting processes to ensure compliance with federal requirements...

US
2025

Medicaid Managed Care Improper Payment Estimate

U.S. Government Accountability Office
Published 2025

The GAO report highlights that while CMS's current improper payment estimates for Medicaid managed care are near zero, they do not capture all program integrity risks. CMS has taken steps to improve o...

US
2025

Oklahoma Focused Program Integrity Review Final Report

Centers for Medicare & Medicaid Services, Center for Program Integrity, Department of Health and Human Services
Published 2025

CMS supports Oklahoma’s efforts and encourages further improvements in program integrity. The review identified four observations for the state’s attention but no non-compliance findings that pose a r...

US
2025

North Carolina’s Medicaid Control Environment, Risk Management Practices, and Governing Processes Were Assessed as Moderate Risk

Office of Inspector General, Department of Health and Human Services
Published 2025

Overall, the audit determined that North Carolina's Medicaid control environment, risk management practices, and governing processes operate at a moderate risk level, with three risk areas rated high ...

IL
2025

Performance Audit of the Health Benefits for Immigrant Seniors and Adults

Office of the Auditor General (Illinois)
Published 2025

The audit revealed significant discrepancies between estimated and actual enrollment and costs, issues with data accuracy and eligibility verification, and the need for improved controls to prevent in...

TN
2024

Performance Audit of Selected Programs and Activities of the Division of TennCare

Comptroller of the Treasury, Division of State Audit
Published 2024

The Division of TennCare has made progress in implementing TennCare III initiatives, unwinding renewals, and maintaining cybersecurity controls, but faces ongoing risks in behavioral health provider n...

US
2024

Colorado's Program Integrity Section Reporting of Medicaid Overpayments

Office of Inspector General, Department of Health and Human Services
Published 2024

Colorado did not report and refund the correct Federal share of Medicaid overpayments identified by its Program Integrity Section during Oct 1, 2014 through Dec 31, 2020; 80 of 403 cases contained unr...

US
2024

Additional Actions Needed to Enhance Program Integrity and Save Billions

United States Government Accountability Office
Published 2024

While CMS has made significant progress in reducing improper payments and implementing GAO recommendations, ongoing efforts and additional actions are necessary to further enhance program integrity, p...

MA
2024

Medicaid Audit Unit—Annual Report

Office of the State Auditor (Massachusetts)
Published 2024

The audit identified an estimated $84,832,094 in capitation payments to MassHealth members residing outside Massachusetts. MassHealth has reported actions or planned actions on all four audit recommen...

US
2023

Multiple States Made Medicaid Capitation Payments to Managed Care Organizations After Enrollees’ Deaths

Office of Inspector General, Department of Health and Human Services
Published 2023

The report concludes that improper Medicaid capitation payments to MCOs on behalf of deceased enrollees remain a persistent issue across states, with prior unallowable payments totaling about $249 mil...

US
2023

Medicaid Program Integrity Opportunities for CMS to Strengthen Use of State Auditor Findings and Collaboration

United States Government Accountability Office
Published 2023

While CMS has taken steps to improve collaboration with state auditors and analyze audit findings, there remains significant room for improvement in using these findings to enhance Medicaid program ov...

US
2023

Oregon Medicaid Managed Care Medical Loss Ratio Audit

Centers for Medicare & Medicaid Services
Published 2023

The audit identified areas for improvement in Oregon's Medicaid managed care MLR reporting and oversight processes. While no immediate remittance was required, implementing the recommendations will en...

CA
2022

Proposition 56 Tobacco Tax The Department Of Health Care Services Is Not Adequately Monitoring Provider Payments Funded By Tobacco Taxes

California State Auditor
Published 2022

Overall, the audit found significant control weaknesses in how Proposition 56 funds and OTP taxes were administered: DHCS did not adequately monitor supplemental payments or provider suspensions in Me...

WA
2021

Medicaid Program Integrity Examining the Health Care Authority’s oversight of efforts at state agencies

Office of the Washington State Auditor
Published 2021

Medicaid is a significant public assistance program in Washington, requiring robust program integrity efforts to ensure proper use of funds. While HCA has taken steps to improve oversight, there are o...

TX
2021
Featured

An Audit Report on Blue Cross Blue Shield of Texas, a Managed Care Organization

State Auditor’s Office
Published 2021

The audit found that while the Health Plan accurately reported medical, administrative, and quality improvement expenses, its pharmacy expense reporting was flawed due to unallowable practices by the ...

CA
2021

Proposition 56 Tobacco Tax State Agencies’ Weak Administration Reduced Revenue by Millions of Dollars and Led to the Improper Use and Inadequate Disclosure of Funds

California State Auditor
Published 2021

The audit concludes that inaccuracies in CDTFA’s tax rate calculation and insufficient safeguards and public disclosure across several agencies impeded program integrity, resulting in potential revenu...

US
2018

Medicaid Managed Care Improvements Needed to Better Oversee Payment Risks

United States Government Accountability Office
Published 2018

The GAO found that Medicaid managed care faces significant payment risks and oversight challenges. CMS's efforts to improve program integrity have been delayed and insufficient, risking continued paym...