Medicare and Medicaid Payments to Providers Are at Risk of Diversion Through Electronic Funds Transfer Fraud Schemes

Date Issued

Tuesday, February 25, 2025

Submitting OIG

Department of Health & Human Services OIG

Agencies Reviewed/Investigated

Department of Health & Human Services

Report Number

OEI-07-23-00180

Report Type

Inspection / Evaluation

Agency Wide

Yes

Number of Recommendations

Questioned Costs

Funds for Better Use

Report updated under NDAA 5274

Open Recommendations

This report has 3 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
25-E-07-017.01	No	$0	$0
CMS should engage Medicare Administrative Contractors regarding opportunities and barriers to improving security measures for EFTs that were reported in response to OIG's survey.
25-E-07-017.02	No	$0	$0
CMS should share information with State Medicaid agencies to help address challenges implementing security measures to protect against EFT fraud.
25-E-07-017.03	No	$0	$0
CMS should support periodic information sharing among Medicare and Medicaid payors and expert groups to mitigate evolving threats of EFT fraud schemes.