Witnesses: Medicaid and SNAP improper payments are usually paperwork errors; inspectors general play key detection role

Witnesses at the House Oversight and Reform Subcommittee on Government Operations said the vast majority of improper payments in Medicaid and the Supplemental Nutrition Assistance Program (SNAP) result from paperwork or administrative errors, not intentional beneficiary fraud.

"Nearly all of the people enrolled in SNAP and Medicaid are eligible for their benefits," Jennifer Wagner of the Center on Budget and Policy Priorities testified, adding that many improper-payment measurements reflect missing documentation rather than ineligible recipients. She cautioned that increased procedural requirements could cut eligible people off and increase improper payments by creating additional opportunities for paperwork error.

Wagner noted federal-state improvements such as ex parte renewals, where data confirm ongoing eligibility without extra paperwork; she cited work by the U.S. Digital Service that enabled more than 5 million people to be renewed with less burden. She also pointed to a 2024 Medicaid eligibility rule aimed at reducing improper payments caused by inadequate records.

Several members pressed witnesses about the role of inspectors general. Ranking Member Kweisi Mfume and others warned that recent dismissals of multiple inspectors general reduced independent oversight and investigative capacity. "We're already in a situation where 10 of 24 agencies subject to the Payment Integrity Information Act were not fully compliant," Mfume said, and he added that firing experienced inspectors general "was the furthest thing from common sense." Witnesses agreed that IG audits and state fraud control units are important for identifying provider fraud and operational errors.

Why it matters: Committee members emphasized that remedies must match root causes. Witnesses warned that overly broad or misdirected reforms aimed at stopping alleged beneficiary fraud could create more harm than benefit by cutting eligible people from programs and straining state agency operations.

Details and evidence

- Root causes: Wagner described many improper payments as the product of missing documentation or case-record maintenance issues rather than deliberate deception by beneficiaries.

- State assistance and technical help: Wagner and other witnesses urged increased federal technical assistance and funding for state systems and staff, noting that under-resourced or antiquated IT and staffing problems contribute to administrative errors.

- Inspector general role: Witnesses and members highlighted the role of IGs and state Medicaid fraud control units in detecting provider fraud and auditing eligibility processes. Members said dismissals of inspectors general have diminished institutional knowledge and transparency.

Ending note: Members on both sides of the aisle described the problem as longstanding and called for targeted, evidence-driven reforms that preserve program access for eligible people while improving data, internal controls, and oversight to reduce improper payments.