VA improper payments for private care drop 98% to $608M in 5 years: GAO

Published Jul 22, 08:24 PM UTC

The Department of Veterans Affairs has reduced improper payments to private companies providing veteran medical care by 98% over five years, from $7.5 billion in 2020 to $608 million in 2025, according to a Government Accountability Office report. Despite Community Care Program outlays rising from $9.5 billion to $25 billion, the improper payment rate dropped from 78% to 2.4%. The GAO noted improper payments stem from outdated claims, incorrect reimbursement rates, and bills exceeding authorized care, with some cases involving fraud. Recent fraud examples include a home health care company submitting $100,000 in fraudulent claims and a provider paying $3.7 million to settle charges. The VA has implemented corrective actions but has not conducted a comprehensive fraud-risk assessment, leaving the program vulnerable. VA officials concurred with the GAO's recommendation to create a fraud-risk framework, with completion expected by March 2028. The report also found CMS improper payments for Medicare Advantage plans rose to $23.7 billion in 2025.