**GAO-08-650T**                      Published: Apr 03, 2008. Publicly Released: Apr 03, 2008.                  

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## Highlights

Medicaid, a joint federal-state program, financed the health care for about 59 million low-income people in fiscal year 2006. States have considerable flexibility in deciding what medical services and individuals to cover and the amount to pay providers, and the federal government reimburses a portion of states' expenditures according to a formula established by law. The Centers for Medicare & Medicaid Services (CMS) is the federal agency responsible for overseeing Medicaid. Growing pressures on federal and state budgets have increased tensions between the federal government and states regarding this program, including concerns about whether states were appropriately financing their share of the program. GAO's testimony describes findings from prior work conducted from 1994 through March 2007 on (1) certain inappropriate state Medicaid financing arrangements and their implications for Medicaid's fiscal integrity and (2) outcomes and transparency of a CMS oversight initiative begun in 2003 to end such inappropriate arrangements.

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## Topics

Health Care

AccountabilityFederal aid to statesFederal fundsFederal lawstate relationsFinancial analysisFinancial managementFunds managementHealth care cost controlHealth care costsHealth care programsHealth care servicesInvestigations by federal agenciesMedicaidMedicarePaymentsProgram managementRequirements definitionStandards evaluationState-administered programsGovernment agency oversightTransparency