**GAO-08-239T**                      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 Medicare and Medicaid providers. Today's testimony covers Medicaid providers who abused the federal tax system from 7 selected states. GAO was asked to (1) determine if Medicaid providers have unpaid federal taxes, and the magnitude of such debts; (2) identify examples of Medicaid providers that have engaged in abusive or related 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 and performed investigative activities.

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## Topics

Health Care

Delinquent taxesFederal taxesHealth care fraudHealth care programsIncome taxesMedicareNoncompliancePersonal income taxesTax administrationTax evasionTax lawTax nonpaymentTax violationsTaxesWithholding taxesPayroll taxesWaste, fraud, and abuse