The improper payment rate in the program was 8.58%, or $50.3 billion, in fiscal year 2023, down from 15.62% in 2022, according to a fact sheet from the agency.
The rate of improper payments in CHIP also decreased from 26.75% in 2022 to 12.81% in 2023.
The decline in improper payments is attributable to flexibility afforded to states during the COVID-19 pandemic and improved state compliance with Medicaid documentation requirements, CMS said in its fact sheet.
Most improper payments in Medicaid and CHIP were the result of insufficient documentation, according to CMS. The agency noted that not all improper payments are fraud or abuse.
“It is important to understand that improper payments are payments that do not meet CMS program requirements, the agency wrote in its fact sheet. “They can be overpayments, underpayments, or payments where insufficient information was provided to determine whether a payment was proper.”
Read the full fact sheet here.
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