VA Community Care and Medicare Advantage reported improper-payment estimates of $608 million and $23.7 billion for fiscal 2025; GAO says both lack comprehensive fraud-risk assessments.
The watchdog says stronger eligibility checks could prevent up to $1 billion a year in health-benefit improper payments, alongside IT and workforce reforms.
Only five of 20 large federally funded, state-administered programs had documented evidence consistent with identifying and prioritizing fraud risks, the watchdog said.