According to an e-alert published by the CMS, improper Medicaid payments hit almost $30 billion last year.

The official statement from the CMS stated the following data: Medicaid’s improper payment rate was 9.8 percent for 2015. This represents $29.12 billion, more than twice the dollar amount in 2013.

This improper payment increase represents nearly double what it was in 2013. The agency is anticipating the 2016 rate to increase to 11.5%.

“States are facing greater challenges keeping pace with stricter enrollment requirements, tracking providers who have been excluded from other states’ or federal health care programs, and generally adapting to changing regulations for qualifications of certain provider types,” CMS said in an alert.

An improper payment can occur when funds go to the wrong recipient, the right recipient receives the incorrect amount of funds, documentation is not available to support a payment or the recipient uses funds in an improper manner. The tally also includes fraudulent claims.

The increase in improper payments is likely due to several factors. The biggest one is that millions of people have joined Medicaid as a result of expansion under the Affordable Care Act.

Until recent years, the CMS didn’t have the ability to track the rate of improper payments as closely as states could, but ongoing technical modernization efforts at the agency may be changing that.

According to Sheree Kanner, former general counsel for the CMS “It’s possible better tracking has resulted in a more accurate picture of inappropriate payments”.

Tony Rodgers, a principal at the firm Health Management Associates and former deputy administrator for strategic planning at the CMS shared that “another issue is that CMS’ improper payment figures may not adequately address questionable billings that have already been corrected by the states”.

To educate states about the issue, the agency has begun using E-Alerts, which informs relevant stakeholders of a concern and the factors that may be causing it. This is believed to be the first time all the possible solutions were outlined in a single document.