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GAO-24-106927: Improper Payments: Information on Agencies' Fiscal Year 2023 Estimates

Summary

GAO-24-106927, Improper Payments: Information on Agencies' Fiscal Year 2023 Estimates, a Government Accountability Office Q&A report to the Subcommittee on Legislative Branch, Committee on Appropriations, House of Representatives, dated March 26, 2024. It is GAO's fifth quarterly report under House Report 117-389. It states that federal agencies estimated a total of $236 billion in improper payments in fiscal year 2023, a decrease of about $11 billion from the prior fiscal year, and that about $175 billion (or 74 percent) were overpayments. In fiscal year 2022, 14 of the 24 CFO Act agencies fully complied with applicable improper payment criteria, as reported by their inspectors general.

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“GAO-24-106927: Improper Payments: Information on Agencies' Fiscal Year 2023 Estimates.” Original at www.gao.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/gao-24-106927-improper-payments-information-on-agencies-fiscal-year-20-2ee300d92b/, SHA-256 03f02c74352764b34f9110e671c2dee78e910e0bf08d6da02a070b08167b1798.

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                       U.S. Government Accountability Office

Improper Payments: Information on Agencies’
Fiscal Year 2023 Estimates
GAO-24-106927
Q&A Report to the Subcommittee on Legislative Branch, Committee on Appropriations, House of
Representatives
March 26, 2024



Why This Matters           Improper payments—those that should not have been made or were made in the
                           incorrect amount—have consistently been a government-wide issue. Since fiscal
                           year 2003, cumulative improper payment estimates by executive branch
                           agencies have totaled about $2.7 trillion. Reducing improper payments is critical
                           to safeguarding federal funds.
                           We have reported on improper payments in our audit reports on the U.S.
                           government’s consolidated financial statements since fiscal year 1997. We have
                           found that these payments represent a material deficiency or weakness in
                           internal controls. Specifically, we have noted that the federal government is
                           unable to determine the full extent of its improper payments or to reasonably
                           assure that appropriate actions are taken to reduce them.
                           House Report 117-389, which accompanied the Legislative Branch
                           Appropriations Act, 2023, includes a provision for GAO to provide quarterly
                           reports on improper payments. This is our fifth such report, and it provides an
                           overview of federal agencies’ improper payment estimates for fiscal year 2023.
                           Additionally, we discuss agencies’ compliance with legal requirements for
                           reporting and managing improper payments.


Key Takeaways              •   In fiscal year 2023, federal agencies estimated a total of $236 billion in
                               improper payments, a decrease of about $11 billion from the prior fiscal year.
                               About $175 billion (or 74 percent) of these improper payments were
                               overpayments.
                           •   The total fiscal year 2023 improper payment estimate does not include some
                               programs that agencies have determined are susceptible to significant
                               improper payments, such as the Department of Health and Humans Services’
                               (HHS) Temporary Assistance for Needy Families (TANF).
                           •   In fiscal year 2022, 14 of the 24 agencies covered by the Chief Financial
                               Officers Act of 1990 (CFO Act) fully complied with applicable improper
                               payment criteria, as reported by their agency inspectors general.


What are the federal    Agencies reported about $236 billion in improper payment estimates for fiscal
agencies’ estimates for year 2023. 1 This amount represents a decrease of about $11 billion from the
fiscal year 2023        fiscal year 2022 estimate (see fig. 1).
improper payments?




Page 1                                                                               GAO-24-106927 Improper Payments
 Figure 1: Total Reported Executive Agency Improper Payment Estimates, Fiscal Years 2003–2023




                               Note: Prior year improper payment estimates have not been adjusted for inflation.

                               Our analysis of agency data shows that 14 agencies reported improper payment
                               estimates across 71 programs. As shown in figure 2, about 79 percent ($186
                               billion) of the government-wide total of estimated improper payments that
                               agencies reported for fiscal year 2023 is concentrated in five program areas:
                                    •    HHS’s Medicare, comprising three programs ($51 billion); 2
                                    •    HHS’s Medicaid ($50 billion);
                                    •    the Department of Labor’s Unemployment Insurance - Federal Pandemic
                                         Unemployment Assistance ($44 billion);
                                    •    the Department of the Treasury’s Earned Income Tax Credit ($22 billion);
                                         and
                                    •    the Small Business Administration’s (SBA) Paycheck Protection Program
                                         Loan Forgiveness ($19 billion).




Page 2                                                                                                        GAO-24-106927 Improper Payments
         Figure 2: Programs Reporting the Largest Percentage of Government-Wide Improper
         Payments Estimates for Fiscal Year 2023




         As seen in figure 3, most of the total $236 billion in government-wide improper
         payment estimates for fiscal year 2023 consisted of overpayments. The
         remaining improper payments consisted of underpayments, unknown payments,
         and technically improper payments. 3

         Figure 3: Agencies’ Fiscal Year 2023 Reported Estimated Improper Payments by Type




         It should be noted that the fiscal year 2023 improper payment estimates do not
         include certain programs that agencies have determined are susceptible to
         significant improper payments. As a result, the government-wide total potentially
         does not represent the full extent of improper payments. For example, the $236
         billion total does not include HHS’s TANF program. HHS reported that it does not
         have the authority to obtain the information it needs to estimate or report
         improper payment amounts for this program. In April 2022, we recommended
         that Congress consider providing HHS the authority to require states to report the
         data the agency needs to estimate and report on improper payments for TANF. 4
         As of February 2024, Congress has not acted on this recommendation.
Page 3                                                                 GAO-24-106927 Improper Payments
How many programs       For fiscal year 2023, nine federal programs reported improper payment estimates
reported improper       of $5 billion or more (see table 1).
payment amounts of at
                        Table 1: Federal Programs Reporting Annual Estimated Improper Payment Amounts of at
least $5 billion?       Least $5 Billion for Fiscal Year 2023
                                                                                                                                     Estimated
                                                                                                                                      improper
                                                                                                                                payment amount
                                                                                                                                     (dollars in
                         Agency                                Program name                                                            billions)
                         Department of Health and
                                                               Medicaid                                                                        $50
                         Human Services
                         Department of Labor                   Federal Pandemic Unemployment Assistance                                         44
                         Department of Health and
                                                               Medicare Fee-for-Service                                                         31
                         Human Services
                         Department of the
                                                               Earned Income Tax Credit                                                         22
                         Treasury
                         Small Business
                                                               Paycheck Protection Program Loan Forgiveness                                     19
                         Administration
                         Department of Health and
                                                               Medicare Advantage (Part C)                                                      17
                         Human Services
                         Department of Agriculture             Supplemental Nutrition Assistance Program                                          9
                         Social Security
                                                               Old Age, Survivors, and Disability Insurance                                       8
                         Administration
                         Social Security
                                                               Supplemental Security Income                                                       5
                         Administration
                        Source: GAO analysis of Office of Management and Budget PaymentAccuracy.gov data. | GAO-24-106927




How many programs       For fiscal year 2023, 16 federal programs reported improper payment rate
reported improper       estimates of at least 10 percent (see table 2).
payment rates of at
least 10 percent?




Page 4                                                                                                               GAO-24-106927 Improper Payments
                       Table 2: Federal Programs Reporting Annual Estimated Improper Payment Rates Greater
                       Than 10 Percent for Fiscal Year 2023
                                                                                                                                      Estimated
                                                                                                                              improper payment
                       Agency                         Program name                                                                rate (percent)
                       Small Business                 Paycheck Protection Program (PPP) Loan Guaranty
                                                                                                                                               49.1
                       Administration                 Purchasesa
                       Small Business
                                                      PPP Loan Forgivenessa                                                                    40.5
                       Administration
                       Department of                  Farm Service Agency Emergency Conservation Program
                                                                                                                                               40.4
                       Agriculture                    – Disasters
                       Department of
                                                      Purchased Long-Term Services and Supports                                                38.7
                       Veterans Affairs
                       Department of Labor Federal Pandemic Unemployment Assistance                                                            35.9
                       Department of the
                                                      Earned Income Tax Credit                                                                 33.5
                       Treasury
                       Department of the
                                                      American Opportunity Tax Credit                                                          31.6
                       Treasury
                       Department of the
                                                      Refundable Premium Assistance Tax Credit                                                 26.0
                       Treasury
                       Department of Labor Federal State Unemployment Insurance                                                                16.5
                       Corporation for
                       National and                   Senior Companion Program                                                                 15.6
                       Community Service
                       Department of the
                                                      Additional Child Tax Credit                                                              14.5
                       Treasury
                       Department of                  Farm Service Agency Livestock Forage Disaster
                                                                                                                                               13.7
                       Agriculture                    Program
                       Department of
                                                      Centers for Medicare & Medicaid Services Children’s
                       Health and Human                                                                                                        12.8
                                                      Health Insurance Program
                       Services
                       Department of
                                                      Supplemental Nutrition Assistance Program                                                11.5
                       Agriculture
                       Department of
                                                      Pension                                                                                  10.9
                       Veterans Affairs
                       Department of
                                                      Noninsured Crop Disaster Assistance Program                                              10.5
                       Agriculture
                       Source: GAO analysis of Office of Management and Budget PaymentAccuracy.gov data. | GAO-24-106927

                       a
                        In fiscal year 2023, the Small Business Administration separated the PPP into three reporting categories—PPP
                       Approvals, PPP Purchases, and PPP Forgiveness. PPP Approvals did not have a population in fiscal year 2023
                       for reporting purposes and last reported in fiscal year 2022.




How many programs      Our analysis of PaymentAccuracy.gov data found that eight programs
reported substantial   experienced substantial declines in reported estimated improper payments for
declines in improper   fiscal year 2023 (see table 3). 5 Agencies attributed these declines to factors such
payments?              as terminating certain programs and implementing mitigation strategies. In
                       addition, variability arising from the improper payment estimation process could
                       potentially explain a portion of the reported declines.




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         Table 3: Federal Programs with Substantial Declines in Estimated Improper Payments from
         Fiscal Years 2022 to 2023
                                                                   Decrease
                                        Estimated                     in rate
                                        fiscal year    Decrease from fiscal
                                                2023 in amount year 2022
                                          improper from fiscal           (net
                                      payments (in year 2022 percentage Agency-cited reason for
         Agency/program                    billions) (in billions)   points) decrease
         Department of                              $50                $30                7.0 Improved state compliance and
         Health and Human                                                                     COVID-19 review flexibilitiesa
         Services –
         Medicaid
         Small Business                             N/A                $29                4.2 Termination of program
         Administration –
         Paycheck
         Protection
         Program Loan
         Approvals
         Department of                                $5               $14                5.7 Termination of two pandemic
         Labor – Federal                                                                      unemployment insurance
         State                                                                                programs
         Unemployment
         Insurance
         Department of                                $0                 $6              12.1 Implementation of effective
         Education –                                                                          mitigation strategies, including
         Education                                                                            providing sufficient time to obtain
         Stabilization Fund                                                                   supporting documentation and
                                                                                              offering targeted technical
                                                                                              assistance
         Department of                                $0                 $5              35.7 Implementation of effective
         Education – Title I                                                                  mitigation strategies, including
         Grants to Local                                                                      providing sufficient time to obtain
         Educational                                                                          supporting documentation and
         Agencies                                                                             offering targeted technical
                                                                                              assistance
         Small Business                               $3                 $4            (3.7)b Winding down of program as
         Administration –                                                                     agency stopped accepting
         COVID-19                                                                             applications and additional
         Economic Injury                                                                      requests for funds
         Disaster Loan
         Department of                                $0                 $3              26.7 Implementation of effective
         Education –                                                                          mitigation strategies, including
         Special Education                                                                    providing sufficient time to obtain
         Grants to States                                                                     supporting documentation and
                                                                                              offering targeted technical
                                                                                              assistance
         Source: GAO analysis of Office of Management and Budget PaymentAccuracy.gov data and agency financial reports. | GAO-24-106927

         a
          According to the Department of Health and Human Services, states were given certain flexibilities during
         COVID-19 which impacted their improper payment reviews, such as suspending eligibility determinations and
         reducing requirements for provider enrollment and revalidations.
         b
          Agency reported decrease in estimated improper payment amount because of decrease in outlays, despite the
         increase in improper payment rate.




Page 6                                                                                                    GAO-24-106927 Improper Payments
How many programs       According to the PaymentAccuracy.gov data that we analyzed, five programs
reported substantial    experienced substantial increases in reported estimated improper payments for
increases in improper   fiscal year 2023 (see table 4). Agencies cited two reasons for these increases:
payments?               not reporting improper payments estimates for the prior fiscal year and making
                        changes in estimation methodology. In addition, variability arising from the
                        improper payment estimation process could potentially explain a portion of the
                        reported increases.

                        Table 4: Federal Programs with Substantial Increases in Estimated Improper Payments from
                        Fiscal Years 2022 to 2023
                                                           Estimated                                    Increase in
                                                           fiscal year           Increase in               rate from
                                                                   2023         amount from              fiscal year
                                                             improper             fiscal year              2022 (net
                                                         payments (in                2022 (in           percentage Agency-cited reason
                         Agency/program                       billions)              billions)               points) for increase
                         Department of Labor                           $44                    $44                  35.9 First time reporting in
                         – Unemployment                                                                                 fiscal year 2023
                         Insurance - Federal
                         Pandemic
                         Unemployment
                         Assistance
                         Small Business                                $19                    $19                  40.5 First time reporting in
                         Administration –                                                                               fiscal year 2023
                         Payment Protection
                         Program Loan
                         Forgiveness
                         Department of                                  $9                      $9                 11.5 Program did not report
                         Agriculture –                                                                                  improper payment
                         Supplemental                                                                                   estimates in fiscal years
                         Nutrition Assistance                                                                           2021 and 2022; resumed
                         Program                                                                                        reporting of improper
                                                                                                                        payment testing in fiscal
                                                                                                                        year 2023
                         Small Business                                 $4                      $4                 49.1 First time reporting in
                         Administration –                                                                               fiscal year 2023
                         Payment Protection
                         Program Loan
                         Guaranty Purchases
                         Department of                                  $3                      $2                   2.2 Refinement of
                         Health and Human                                                                                methodology used to
                         Services – Medicare                                                                             recognize payment errors
                         Prescription Drug
                         Benefit (Part D)
                        Source: GAO analysis of Office of Management and Budget PaymentAccuracy.gov data and agency financial reports. | GAO-24-106927




What legal              The Payment Integrity Information Act of 2019 (PIIA) requires executive branch
requirements do         agencies to, among other things, (1) review all programs and activities and
agencies have for       identify those that may be susceptible to significant improper payments
managing improper       (commonly referred to as conducting a risk assessment), (2) publish improper
                        payment estimates for those programs and activities that the agency identified as
payments?
                        being susceptible to significant improper payments, (3) implement corrective
                        actions to reduce improper payments and set reduction targets, and (4) report on
                        the results of addressing the foregoing requirements. 6

                        The Office of Management and Budget (OMB) plays a key role in developing
                        guidance for executive branch agencies on estimating and reporting on improper
Page 7                                                                                                                  GAO-24-106927 Improper Payments
         payments. OMB Circular No. A-123, appendix C, includes guidance for
         inspectors general (IG) on how to determine agency compliance with applicable
         PIIA criteria. 7 It also includes guidance for executive branch agencies on the
         corrective actions that PIIA requires them to take if they are found noncompliant.
         In addition, PIIA requires the IG at each executive branch agency to issue an
         annual report on the agency’s compliance with applicable PIIA criteria. 8

         As shown in figure 4, PIIA and OMB M-21-19 include criteria for compliance.



         Figure 4: Compliance with Payment Integrity Information Act of 2019 Criteria and Related
         Office of Management and Budget Requirements




         Specifically, OMB instructs IGs to report on whether their agencies are compliant
         with the following 10 criteria.
         1a. publish payment integrity information with their annual financial statements,
         1b. post their annual financial statements and accompanying materials on their
         websites,
         2a. conduct improper payment risk assessments for each program with annual
         outlays greater than $10 million at least once in the last 3 fiscal years,
         2b. adequately conclude whether each program is likely to make improper
         payments and unknown payments above or below the statutory threshold (either
         $100 million or both 1.5 percent of program outlays and $10 million),


Page 8                                                                    GAO-24-106927 Improper Payments
                          3. publish improper payment and unknown payment estimates for programs
                          susceptible to significant improper payments and unknown payments in the
                          accompanying materials to the annual financial statements,
                          4. publish corrective action plans for each program for which an estimate above
                          the statutory threshold was published in the accompanying materials to the
                          annual financial statements,
                          5a. publish an improper payment and unknown payment reduction target for
                          each program for which an estimate above the statutory threshold was published
                          in the accompanying materials to the annual financial statements,
                          5b. demonstrate improvements to payment integrity or reach a tolerable improper
                          payment and unknown payment rate,
                          5c. develop a plan to meet their improper payment and unknown payment
                          reduction targets, 9 and
                          6. report improper payment and unknown payment estimates of less than 10
                          percent for each program for which they published estimates in the
                          accompanying materials to their annual financial statements.

                          The criteria described above do not apply to all programs or agencies. For
                          example, if an agency determines through its risk assessment that none of its
                          programs or activities are susceptible to significant improper payments, criteria
                          three through six would not be applicable. If an IG concludes that any of the
                          agency’s programs or activities fail to meet any of the applicable criteria, the
                          agency is considered noncompliant under PIIA for that fiscal year and is required
                          to take additional actions for each year it is noncompliant, such as providing
                          OMB with a description of the actions that the agency will take to come into
                          compliance.

How many CFO Act       In fiscal year 2022, 14 of the 24 CFO Act agencies fully complied with PIIA
agencies complied with criteria and related OMB requirements, according to their IGs. 10 This was an
the legal criteria for increase from fiscal year 2021, when IGs reported 10 agencies were compliant.
managing improper      Figure 5 provides a 7-year comparison of agency compliance rates, as reported
payments in recent     by agency IGs. 11
years?




Page 9                                                                              GAO-24-106927 Improper Payments
          Figure 5: CFO Act Agencies’ Compliance with PIIA or IPERA Criteria for Fiscal Years 2016
          through 2022, as Reported by Their IGs




          The increase in compliance with PIIA and related OMB criteria from fiscal years
          2021 to 2022 is attributable to four previously noncompliant agencies becoming
          compliant. 12 Additionally, no previously compliant agencies became
          noncompliant.

          As shown in figure 6, each of the 10 criteria had at least one instance of
          noncompliance in fiscal year 2022. However, all 24 CFO Act agencies complied
          with at least one of the 10 PIIA-related OMB requirements. A few criteria had
          relatively high noncompliance rates. For example, excluding agencies for which
          the criterion was inapplicable, IGs found that half of agencies had at least one
          program reporting an estimate of over 10 percent (criterion 6).




Page 10                                                                   GAO-24-106927 Improper Payments
          Figure 6: CFO Act Agencies’ Compliance with PIIA and OMB Criteria for Fiscal Year 2022, as
          Reported by Their IGs




          IGs identified various causes for agencies’ noncompliance with these criteria and
          published numerous findings and recommendations for improvements.

          •   High improper payment rate estimates. Seven agencies (Department of
              Agriculture (USDA), Department of Education, HHS, Department of Labor
              (DOL), Treasury, Department of Veterans Affairs (VA), and Small Business
              Administration (SBA)) were found to be noncompliant with OMB criterion 6. In
              addition, two of these agencies (Labor and VA) received new
              recommendations to reduce their improper payment rate estimates below the
              10 percent threshold. For example, Labor reported a combined improper and
              unknown payment rate of 22.2 percent for its Unemployment Insurance
              program in fiscal year 2022, which exceeded the 10 percent threshold
              established by PIIA. As a result, its IG recommended that Labor maintain its
              current focus on increasing technical assistance and funding to states to
              improve the improper payment reduction strategies and thereby reduce the
              improper payments estimate rate.

          •   Inadequate risk assessments. Three agencies (USDA, Department of
              Homeland Security (DHS), and Environmental Protection Agency (EPA))
              were found to be noncompliant with OMB criteria 2a or 2b. In addition, six
              agencies (USDA, Department of Housing and Urban Development (HUD),
              Treasury, DHS, National Aeronautics and Space Administration, and SBA)
              received new recommendations to modify their risk assessment
              methodologies or update their related processes. Three others (Department
              of the Interior, EPA, and HHS) had open risk assessment-related

Page 11                                                                   GAO-24-106927 Improper Payments
                       recommendations from prior years. For example, Treasury’s auditor reported
                       that the agency did not sufficiently review its risk assessments, with some risk
                       assessment questions including inaccurate responses and justifications that
                       did not properly support the responses. 13 According to the Treasury IG’s
                       report, the lack of sufficient reviews can lead to an inaccurate assessment of
                       a program’s susceptibility to improper payments, increasing the likelihood for
                       management to miss taking proper actions over the program’s improper
                       payments. As a result, Treasury’s auditor recommended that the agency
                       complete sufficient reviews of the program-specific risk assessments to better
                       prevent this issue from reoccurring.

                   •   Unreliable estimates. Five agencies (HUD, Department of Defense, Labor,
                       HHS, and SBA) were designated as noncompliant with OMB criterion 3.
                       These five and one additional agency, Education, received new
                       recommendations to address their unreliable improper payment estimates.
                       For example, HUD did not report improper payment estimates for the Office
                       of Public and Indian Housing’s Tenant Based Rental Assistance program and
                       the Office of Multifamily Housing’s Project-Based Rental Assistance
                       program. 14 These programs spent $41 billion in fiscal year 2022, which
                       represented 61.6 percent of HUD’s total expenditures. According to its IG’s
                       office, HUD did not report improper payment estimates for these programs
                       because it was not successful in planning and developing a platform to collect
                       and secure supporting documentation that contained personally identifiable
                       information. As a result, HUD IG recommended that the agency develop and
                       complete a detailed plan and timeline for these estimates in time for its fiscal
                       year 2023 reporting.

Agency Comments    We provided a draft of this report to OMB for review and comment. OMB did not
                   have any comments on the report.


How GAO Did This   To conduct this work, we compiled improper payment estimates from OMB’s
Study              PaymentAccuracy.gov website. We summarized and compared the improper
                   payment estimates to identify any substantial changes in fiscal years 2022 to
                   2023. A substantial change in improper payments is one in which the estimated
                   improper payment amount changed by at least $1 billion, and the improper
                   payment rate changed more than the reported margin of error for the agency
                   estimate of improper payments. We reviewed the agencies’ agency financial
                   reports or performance and accountability reports and PaymentAccuracy.gov
                   website to determine what factors agencies identified as the causes for these
                   changes. In addition, we reviewed the fiscal year 2022 PIIA criteria compliance
                   reports issued by each agency’s IG.


                   We conducted this performance audit from July 2023 to March 2024 in
                   accordance with generally accepted government auditing standards. Those
                   standards require that we plan and perform the audit to obtain sufficient,
                   appropriate evidence to provide a reasonable basis for our findings and
                   conclusions based on our audit objectives. We believe that the evidence
                   obtained provides a reasonable basis for our findings and conclusions based on
                   our audit objectives.




Page 12                                                                       GAO-24-106927 Improper Payments
List of Addressees   The Honorable Mark E. Amodei
                     Chairman
                     The Honorable Adriano Espaillat
                     Ranking Member
                     Subcommittee on Legislative Branch
                     Committee on Appropriations
                     House of Representatives

                     We are sending copies of this report to the appropriate congressional committees
                     and the Director of the Office of Management and Budget. In addition, the report
                     is available at no charge on the GAO website at https://www.gao.gov.
.




GAO Contact          For more information, contact: M. Hannah Padilla, Director, Financial
Information          Management and Assurance, PadillaH@gao.gov , (202) 512-5683
                     Chuck Young, Managing Director, Public Affairs, YoungC1@gao.gov, (202) 512-
                     4800
                     A. Nicole Clowers, Managing Director, Congressional Relations,
                     ClowersA@gao.gov, (202) 512-4400
                     Staff Acknowledgments: Matt Valenta (Assistant Director), Laura Pacheco
                     (Analyst-in-Charge), Seth Brewington, Marcia Carlsen, Tabitha FitzGibbon,
                     Jason Kelly, Jenny Lee, Sarah Lisk, and Megan Jones.
                     Connect with GAO on Facebook, Flickr, Twitter, and YouTube. Subscribe to our
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                     Visit GAO on the web at https://www.gao.gov.
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                     https://www.gao.gov/copyright


Endnotes
                     1An improper payment is defined by law as any payment that should not have been made or that

                     was made in an incorrect amount (including overpayments and underpayments) under statutory,
                     contractual, administrative, or other legally applicable requirements. It includes any payment to an
                     ineligible recipient, any payment for an ineligible good or service, any duplicate payment, any
                     payment for a good or service not received (except for such payments where authorized by law),
                     and any payment that does not account for credit for applicable discounts. 31 U.S.C. § 3351(4).
                     When an executive agency’s review is unable to discern whether a payment was proper because of
                     insufficient or lack of documentation, this payment must also be included in the improper payment
                     estimate. 31 U.S.C. §3352(c)(2).

                     2Medicare is composed of the Medicare Fee-For-Service, Medicare Advantage (Part C), and

                     Medicare Prescription Drug (Part D) programs.

                     3OMB’s PaymentAccuracy.gov data call for fiscal year 2023 included guidance for agencies to use

                     when reporting the types of their estimated improper payments. This guidance was in addition to
                     that provided in OMB M-21-19 on reporting estimates for programs or activities that are identified
                     as susceptible to improper payments. According to OMB M-21-19, “overpayments” are payments
                     exceeding the amount due, and are payments that, in theory, should or could be recovered.
                     “Underpayments” are those in which recipients did not receive the funds to which they were
                     entitled. “Unknown payments” are those that a program cannot determine were either proper or
                     improper. “Technically improper payments” are those in which recipients received funds they were
                     entitled to, but the payment failed to follow all applicable statutes or regulations.

                     4GAO, COVID-19: Current and Future Federal Preparedness Requires Fixes to Improve Health

                     Data and Address Improper Payments, GAO-22-105397 (Washington, D.C.: Apr. 27, 2022).



Page 13                                                                                     GAO-24-106927 Improper Payments
          5PaymentAccuracy.gov is an official U.S. government website managed by OMB. It contains,

          among other things, information about current and historical rates (i.e., agency-reported amounts
          as a percentage of outlays) and amounts of improper payments, root causes of monetary loss and
          improper payments, monetary-loss recovery efforts, and high-priority program scorecards. In
          addition, for purposes of this report, a program that has experienced a substantial decline or
          increase in improper payments is one in which the estimated improper payments amount
          decreased or increased by at least $1 billion, and the improper payment rate decreased or
          increased more than the reported margin of error for the agency estimate of improper payments.
          This latter condition reduces but does not eliminate the possibility that the observed declines or
          increases are due to variability arising from the improper payment estimation process. For two
          programs—(1) COVID-19 Economic Injury Disaster Loan Emergency Assistance and (2) COVID-19
          Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine
          Administration for the Uninsured Program—the reported confidence intervals for the fiscal years
          2022 and 2023 estimates overlap, which indicates a greater risk that variability resulting from the
          estimation process could explain all or a substantial part of the observed declines for those
          programs.

          631 U.S.C. § 3352.


          7OMB M-21-19, issued on March 5, 2021, became effective starting in fiscal year 2021.


          831 U.S.C. § 3353(a).


          9OMB M-21-19’s criteria 5a, 5b, and 5c relate to 31 U.S.C. § 3351(2)(E), which states that

          compliance means that the executive agency “publishes improper payment reductions targets
          prepared under [31 U.S.C. § 3352(d)] that the executive agency may have in the accompanying
          materials to the annual financial statement for each program or activity assessed to be at risk, and
          has demonstrated improvements and developed a plan to meet the reduction targets.”

          10The CFO Act, Pub. L. No. 101-576, 104 Stat. 2838 (Nov. 15, 1990) (codified as amended in

          scattered sections of 31 U.S.C.), among other things, established chief financial officers to oversee
          financial management activities at 23 major executive departments and agencies. The list now
          includes 24 entities, which are often referred to collectively as CFO Act agencies, and is codified as
          amended at 31 U.S.C. § 901(b). We focused on the 24 CFO Act agencies because the improper
          payment estimates for those agencies accounted for over 99 percent of the federal government’s
          reported estimated improper payments for fiscal year 2022. However, PIIA applies to both CFO Act
          and non-CFO Act executive agencies. According to PaymentAccuracy.gov, 41 out of the 55
          executive branch agencies reporting in fiscal year 2022 were determined by their respective IGs to
          be compliant with PIIA criteria. In addition, IGs are required to issue compliance reports under PIIA.
          31 U.S.C. § 3353. Per OMB M-21-19, the compliance reports are due within 180 days following the
          publishing of agencies’ annual financial statements and accompanying materials, which typically
          occurs in mid-November. The most recent IG compliance reports available were issued in 2023 for
          agencies’ fiscal year 2022 compliance with PIIA criteria.

          11This comparison includes Improper Payments Elimination and Recovery Act of 2010 (IPERA)

          (Pub. L. No. 111-204, 124 Stat. 2224) requirements for fiscal years prior to 2020 and PIIA
          requirements for fiscal year 2020 onward. IPERA established a requirement for agency IGs to
          report annually on their respective agencies’ compliance. In March 2020, Congress and the
          President enacted PIIA, which repealed IPERA and the other improper payments reporting-related
          statutes and enacted substantially similar provisions, including those related to IGs’ reporting on
          agency compliance with criteria and the compliance criteria themselves. Pub. L. No. 116-117, 134
          Stat. 113 (codified at 31 U.S.C. §§ 3351-58).

          12The four agencies that became compliant with applicable PIIA criteria in fiscal year 2022 were the

          Environmental Protection Agency, National Aeronautics and Space Administration, Office of
          Personnel Management, and Social Security Administration.

          13Department of the Treasury, Office of Inspector General, Audit of Treasury’s Compliance with the

          PIIA Requirements for Fiscal Year 2022, OIG-23-026 (Washington, D.C.: May 2023).

          14Department of Housing and Urban Development, Office of Inspector General, HUD Did Not

          Comply With the Payment Integrity Information Act of 2019, 2023-FO-0009 (Washington, D.C.: May
          2023).




Page 14                                                                           GAO-24-106927 Improper Payments


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