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$95.5 billion: Health care money paid with no proof it was right
Medicare, Medicaid and CHIP paid about $95.5 billion in error in fiscal 2025. Most of it lacked the paperwork to show it was correct.
Medicare, Medicaid, CHIP
- Medicaid$37.39B (6.12%)1
- Medicare fee-for-service$28.83B (6.55%)1
- Medicare Advantage$23.67B (6.09%)1
- Medicare Part D drugs$4.23B (4.00%)1
- CHIP$1.37B (7.05%)1
- Total of the five$95.49B1
- Medicaid errors caused by missing documentation77.17%1
- Fraud share████████████████
What happened
Each year the Centers for Medicare & Medicaid Services samples claims and estimates how much it paid in error. For fiscal 2025 the five big programs add up to about $95.5 billion.
Most of it wasn't a wrong amount. It was a payment nobody could prove was right, because the records weren't there.
Why nobody caught it
- In Medicaid, 77 percent of improper payments came from insufficient documentation.
- CMS says missing paperwork is generally not a sign of fraud. It also means nobody can check.
How sure are we?
Officially counted as paid in error or without the records to prove it was right. Some is fraud. Nobody has measured how much.
CMS says improper payments are not a measure of fraud. That is the point of this page: without a receipt, no one can tell the difference.
Sources
- Fiscal year 2025 improper payments fact sheetCenters for Medicare & Medicaid Services · Jan 15, 2026
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