In the United States, national health expenditures totaled three trillion dollars in 2014. This amounts to total spending of $9,523.00 per person. Medicaid accounts for 11 percent of national health expenditures, according to Centers for Medicare & Medicaid Services. In total, $495.8 billion was paid out in Medicaid payments during the course of the 2014 year.
This money is taxpayer money, and the expenditures are justified by the fact Medicaid is supposed to provide care for the poor and the vulnerable. Unfortunately, this is not always what is happening- and a big part of why there is so much spending is because a significant number of healthcare providers abuse the Medicaid payment systems or take advantage of the Medicaid program by making improper claims. When providers do this, they harm Medicaid's ability to do its job - help the vulnerable who are depending upon Medicaid to provide them with necessary medical services.
Whistleblowers play a very important role in fighting Medicaid fraud and abuse. When a whistleblower successfully comes forward with a fraud claim and the government is able to recover money as a result, the whistleblower gets a portion of the money recovered
National Review recently published a comprehensive article on the " staggering" cost of Medicaid fraud. According to the article, the Department of Health and Human Services was forced to issue a warning about how big the Medicaid problem has become.
Since the total amount of improper payments across all federal programs is close to $140 billion, these numbers demonstrate Medicaid is one of the biggest drivers of improper payments of any government program. Approximately seven times as much is being spent on illegal and improper federal payments as is spent on NASA and approximately 20 times as much money is being improperly paid out as is spent on the National Science Foundation.
The rate of improper Medicaid payments has nearly doubled over the course of recent years, which National Review attributes to the "liberalization of Medicaid-eligibility rules," which was put into place by the Patient Protection and Affordable Care Act (PPACA). Whatever the reason for the cause of so many improper Medicaid payments, it is important for everyone to do their part and come forward to blow the whistle if they find fraud in the Medicaid system.