**GAO-08-17**                      Published: Nov 14, 2007. Publicly Released: Nov 14, 2007.                  

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## Highlights

In fiscal year 2006, outlays for Medicaid were about $324 billion; about $185 billion was paid by the federal government. Because GAO previously identified abusive and criminal activity associated with government contractors owing billions of dollars in federal taxes, the subcommittee requested GAO expand our work to Medicaid providers. GAO was asked to (1) determine if Medicaid providers have unpaid federal taxes, and if so, the magnitude of such debts; (2) identify examples of Medicaid providers that have engaged in abusive or criminal activities; and (3) determine whether the Centers for Medicare & Medicaid Services (CMS) and the states prevent health care providers with tax problems from enrolling in Medicaid or participating in the continuous levy program to pay federal tax debts. To perform this work, GAO analyzed tax data from the Internal Revenue Service (IRS) and Medicaid data from seven selected states based on magnitude of Medicaid payments and geography. GAO also performed additional investigative activities.

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## Topics

Health Care

Access to health careFederal taxesHealth care programsIncome taxesManaged health careMedicareNoncompliancePersonal income taxesProgram abusesSocial security taxesTax administrationTax lawTax violationsstate relationsPayroll taxes