Efforts Needed To Relieve Medicaid From Paying for Services Covered by Private Insurers

GAO discussed efforts to reduce Medicaid costs by identifying and collecting from private health and liability insurance companies the amount they are legally liable to pay for services received by Medicaid recipients. Although the Medicaid program should be relieved of health care costs if another party is legally responsible for payment, states continue to receive bills from eligible recipients who have coverage with private health and liability insurance companies. The Health Care Financing Administration (HFCA) estimates that Medicaid pays annually $500 million to more than $1 billion that private insurers should be paying. GAO believes that HCFA should ensure that states have effective programs for identifying and using available insurance resources.