Medicare Advantage

GAO reports $162 billion in improper payments across 68 federal programs in FY2024, down from FY2023 due to COVID program wind-downs, but 75% concentrated in five key areas with persistent weak documentation and eligibility controls.[web:53] CMS details $31.7B in Medicare FFS, $19.1B in Part C, and $31.1B in Medicaid improper payments for FY2024, primarily from insufficient documentation.[web:54] HHS OIG October 2024 audit reveals Medicare Advantage plans using questionable health risk assessments to inflate payments by billions, confirming ongoing overpayments.[web:61] FY2025 estimates rise to $186B government-wide.[web:23]