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GAO: CMS Should Ensure Quality of Medicaid Data for Oversight Purposes

The Government Accountability Office has called on the Centers for Medicare and Medicaid Services to initiate efforts to evaluate and ensure the quality of Medicaid data for use in program oversight.

CMS should also speed up efforts to review data in the Transformed Medicaid Statistical Information System, GAO said in a report published Monday.

GAO made the recommendation after it evaluated Medicaid utilization and expenditure data and found that the healthcare program made approximately $36 billion in improper payments in fiscal 2016.

The congressional budget watchdog found that CMS’ Medicaid expenditure data do not offer accurate and complete information on how states fund their share of program costs.

GAO also raised issues on the timeliness and completeness of Medicaid utilization data, specifically for managed care.

CMS told GAO that 18 states started to submit T-MSIS data as of October 2016 and cited states’ efforts to replace their Medicaid information technology platforms as one of the factors that delayed the T-MSIS implementation.


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