Medicaid: 25 ways states game the system

The Department of Health and Human Services has identified the key problems the Centers for Medicare & Medicaid Services need to address to ensure that states pay their fair share of the state-federal low income insurance program.

The Washington Post: How States Have Gamed Medicaid For Hundreds Of Millions Of Dollars
States have developed various ways to avoid paying their fair share of Medicaid expenses over the years, in some cases costing the federal government hundreds of millions of dollars in extra funding for the program. The Department of Health and Human Services, which runs Medicaid through its Centers for Medicare and Medicaid Services (CMS), has known about the issue for more than a decade, but states still find ways to game the system. The agency's inspector general this year listed the issue among 25 key problems the agency needs to address (Hicks, 9/15).

Also in the news, a report details how the American wealth gap is putting the squeeze on state revenue and spending for Medicaid -

The Associated Press: US Wealth Gap Putting The Squeeze On State Revenue
As the growth of tax revenue has slowed, states have faced tensions over whether to raise taxes or cut spending to balance their budgets as required by law. "Rising income inequality is not just a social issue," said Gabriel Petek, the S&P credit analyst who wrote the report. "It presents a very significant set of challenges for the policymakers." Stagnant pay for most people has compounded the pressure on states to preserve funding for education, highways and social programs such as Medicaid. Their investments in education and infrastructure have also fueled economic growth. Yet they're at risk without a strong flow of tax revenue (9/15).