<figure class="wp-block-table"><table class="has-fixed-layout"><tbody><tr><td>Matter</td><td>Amount</td><td>Status</td></tr><tr><td>Federal improper payments, FY2025</td><td>About $186 billion across 64 programs at 15 agencies</td><td>Improper payment estimate (GAO, Apr 27, 2026)</td></tr><tr><td>Overpayments, FY2025</td><td>About $153 billion (82% of the total)</td><td>Improper payment estimate (GAO, Apr 27, 2026)</td></tr><tr><td>Increase from FY2024</td><td>$24 billion</td><td>Improper payment estimate (GAO, Apr 27, 2026)</td></tr><tr><td>Medicare Fee-for-Service</td><td>$28.83 billion (6.55% rate)</td><td>Improper payment estimate (CMS, FY2025)</td></tr><tr><td>Medicare Advantage (Part C)</td><td>About $23.7 billion (6.09% rate)</td><td>Improper payment estimate (CMS, FY2025)</td></tr><tr><td>Medicaid</td><td>About $37.4 billion (6.12% rate)</td><td>Improper payment estimate (CMS, FY2025)</td></tr><tr><td>Earned Income Tax Credit</td><td>About $21.1 billion (32.7% rate)</td><td>Improper payment estimate (IRS, FY2025)</td></tr><tr><td>SNAP</td><td>About $10.1 billion (10.62% error rate)</td><td>Payment error rate (FY2025)</td></tr><tr><td>ACA premium tax credits, federal exchange</td><td>$657.46 million (0.89% rate)</td><td>Improper payment estimate (CMS, FY2025)</td></tr><tr><td>Programs at or above 10%</td><td>19 programs; 6 above 25%</td><td>Improper payment estimate (GAO, FY2025)</td></tr><tr><td>Cumulative estimates since FY2003</td><td>About $3 trillion</td><td>Improper payment estimate (GAO)</td></tr></tbody></table></figure>

Key facts

An improper payment is a payment that should not have been made, was made in the wrong amount, went to an ineligible recipient or lacked enough documentation to determine whether it was correct.



The category includes:



– Overpayments: The recipient or provider received more than allowed.



– Underpayments: The government paid less than the correct amount.



– Payments to ineligible recipients: Eligibility rules were not satisfied.



– Insufficiently documented payments: Reviewers could not confirm that the payment met program requirements.



– Technically improper payments: The payment may have served an eligible person but failed a procedural or documentation rule.



– Unknown payments: Available records were insufficient to decide whether the payment was correct.



An improper payment may result from fraud, an administrative mistake, outdated information, an incorrect eligibility determination, inadequate documentation or a calculation error.

What is an improper payment?

Fraud involves obtaining money or another benefit through willful misrepresentation. Intentional deception separates fraud from an ordinary mistake.



The Government Accountability Office explains that fraudulent payments are improper, but many improper payments result from causes other than fraud. The federal estimation process was designed to measure payment accuracy.



A fraud finding usually requires additional evidence, such as fabricated records, knowingly false statements, concealed ownership, billing for services never provided or an admission of wrongdoing. Criminal responsibility is established through a guilty plea or court judgment.



For additional definitions, see the <a href="https://www.tpaction.com/government-fraud-waste-and-corruption-the-plain-english-glossary/">Government Fraud, Waste and Corruption Plain-English Glossary</a>.

How is fraud different?

GAO reported that 15 federal agencies estimated approximately $186 billion in improper payments across 64 programs during fiscal year 2025. That was $24 billion more than the estimate for fiscal year 2024. Read the <a href="https://www.gao.gov/products/gao-26-108694">GAO report</a>.



Approximately $153 billion consisted of overpayments. The remainder included underpayments and payments whose accuracy could not be established.



Federal agencies have reported about $3 trillion in cumulative improper-payment estimates since fiscal year 2003. GAO cautioned that the total remains incomplete because some programs considered vulnerable to significant improper payments did not publish estimates.



The $186 billion is therefore:



An annual statistical estimate



Based on agency-specific sampling and measurement methods



A combination of several payment-error categories



Broader than adjudicated fraud



Incomplete as a government-wide total



Separate from restitution or money recovered

What does the $186 billion represent?

Medicare Fee-for-Service pays healthcare providers for covered services delivered to eligible beneficiaries.



For fiscal year 2025, the Centers for Medicare &amp; Medicaid Services estimated a 6.55 percent improper-payment rate, representing approximately $28.83 billion, down from 7.66 percent, or $31.70 billion, in fiscal year 2024. The estimate is based on claims submitted from July 1, 2023 through June 30, 2024, according to <a href="https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/comprehensive-error-rate-testing-cert/improper-payment-rates-and-additional-data">CMS</a>.



Common causes include insufficient medical documentation, coding problems, missing provider information and services that did not meet coverage requirements. A missing record can make a payment improper even when a patient received treatment.



The $28.83 billion is an improper-payment estimate.



Stronger controls include prepayment review of high-risk claims, provider screening, automated coding checks, duplicate-claim detection and confirmation that medical records support the billed service.

Medicare Fee-for-Service

Medicare Advantage, also known as Medicare Part C, pays private plans a monthly amount based partly on each enrollee’s documented health conditions.



CMS reported approximately $23.67 billion in estimated improper payments for fiscal year 2025, a 6.09 percent rate, up from 5.61 percent in fiscal year 2024. Most errors involved diagnosis information that the plan’s supporting documentation did not substantiate.



An unsupported diagnosis can increase a plan’s payment. Proving fraud would require evidence that a plan or provider knowingly submitted or retained false information.



Important safeguards include medical-record validation, audits of high-risk diagnoses, comparisons across providers and recovery of confirmed overpayments.

Medicare Advantage

Medicaid is jointly funded by federal and state governments but administered primarily through state programs.



Fiscal year 2025 Medicaid improper payments were estimated at 6.12 percent, or approximately $37.39 billion, up from 5.09 percent in fiscal year 2024, based on state reviews conducted in 2023, 2024 and 2025. CMS attributed the increase to the effects of unwinding flexibilities given to states during the COVID-19 public health emergency and reported that 77.17 percent of the Medicaid improper payments resulted from insufficient documentation, according to its <a href="https://www.cms.gov/newsroom/fact-sheets/fiscal-year-2025-improper-payments-fact-sheet">fiscal year 2025 improper payments fact sheet</a>.



Medicaid errors may involve ineligible recipients, unqualified providers, missing documentation, incorrect billing codes or services that do not comply with program requirements. Criminal cases involving billing for services never provided represent fraud, but administrative eligibility errors remain a different category.



Arizona’s Medicaid record demonstrates why this distinction matters. Provider convictions and guilty pleas establish fraud in particular cases. Program-wide exposure estimates and suspended-provider claims carry different statuses. Read <a href="https://www.tpaction.com/arizonas-2-8-billion-medicaid-sober-living-fraud-timeline-oversight-failures-and-what-is-still-happening/">Arizona’s $2.8 Billion Medicaid Sober-Living Fraud Timeline</a> for the state-specific record.

Medicaid

The Earned Income Tax Credit is a refundable federal tax credit for qualifying workers and families.



For fiscal year 2025, the Internal Revenue Service estimated approximately $21.1 billion in improper EITC payments, equal to 32.7 percent of roughly $64.7 billion in total payments.



Errors can arise from incorrect income, filing-status, residency or qualifying-child information. Some claims involve deliberate deception; others result from complex eligibility rules, inaccurate records or misunderstandings.



Because the improper-payment rate exceeded 25 percent, EITC payment accuracy remained a major control concern. Effective responses include income data matching, dependent-claim checks, preparer oversight and earlier verification of conflicting information.

Earned Income Tax Credit

SNAP provides food benefits through state-administered eligibility and payment systems.



The national fiscal year 2025 payment-error rate was 10.62 percent, representing approximately $10.1 billion in combined overpayments and underpayments.



SNAP errors may involve inaccurate household income, household composition, deductions or state processing. The payment-error rate is a statistical measure of benefit accuracy.



Data matching with employment, tax and residency records can reduce errors. States also need trained eligibility workers, documented verification procedures and timely reviews when household circumstances change.

Supplemental Nutrition Assistance Program

Unemployment Insurance is administered through state systems using a combination of state and federal requirements.



The program has repeatedly reported elevated improper-payment rates. Causes include payments made after recipients returned to work, identity theft, inaccurate wage information, eligibility errors and failures to meet job-search requirements.



Pandemic-era expansions exposed weaknesses in identity verification and cross-state data sharing. Criminal identity-theft schemes constituted fraud, while processing errors and delayed wage information produced other improper payments.



Necessary controls include identity verification before payment, employer-data matching, checks across state systems, device and address analytics, and rapid review of duplicate claims.

Unemployment Insurance

Advance Premium Tax Credits help eligible households pay premiums for health insurance purchased through qualifying marketplaces.



For fiscal year 2025, CMS estimated approximately $657.46 million in improper payments for the federally facilitated exchange, an estimated rate of 0.89 percent.



Errors can occur when projected household income differs from actual income, eligibility information is not updated or supporting records are unavailable. Tax reconciliation may later recover excess credits.



Potential enrollment fraud requires evidence of intentional false information, unauthorized enrollment or manipulation of consumer data.

Affordable Care Act premium tax credits

GAO identified seven agencies with programs reporting estimated improper-payment rates of at least 10 percent for two, three or four consecutive fiscal years between 2021 and 2024.



Programs remaining above the threshold for multiple years face added reporting requirements under the Payment Integrity Information Act. Agencies must explain their corrective actions and, in some cases, submit proposals for bringing programs into compliance.



GAO found that five of the seven agencies lacked sufficiently documented procedures for consistently tracking and submitting required information. Several reports were also submitted late or not provided to every required recipient.



For fiscal year 2025, 19 programs reported estimated improper-payment rates of at least 10 percent, and six exceeded 25 percent. These rates measure the proportion of payments estimated to be improper.

Which programs remained above 10 percent?

<h3 class="wp-block-heading">Eligibility verification</h3>



Programs should confirm income, residency, household composition and other qualifying conditions before issuing benefits. Information should be rechecked when circumstances change.



<h3 class="wp-block-heading">Provider and recipient screening</h3>



Agencies should verify identities, licenses, ownership structures, exclusion histories and related businesses. High-risk providers may require site visits or additional documentation before receiving payments.



<h3 class="wp-block-heading">Billing controls</h3>



Automated rules can identify impossible service hours, invalid codes, unusual payment growth and claims unsupported by eligibility records.



<h3 class="wp-block-heading">Duplicate-claim detection</h3>



Data should be compared across providers, programs, states, addresses and taxpayer-identification numbers. Cross-program analysis can expose repeated or overlapping claims.



<h3 class="wp-block-heading">Prepayment and post-payment review</h3>



Prepayment controls prevent questionable claims from leaving the Treasury. Post-payment audits test whether completed payments complied with program rules and may support recovery.



<h3 class="wp-block-heading">Enforcement and recovery</h3>



Confirmed misconduct may lead to administrative exclusions, civil settlements, criminal charges, restitution or forfeiture. Each amount should be reported according to its current status.

Which controls can reduce improper payments?

In its January 15, 2026 <a href="https://www.cms.gov/newsroom/fact-sheets/fiscal-year-2025-improper-payments-fact-sheet">fiscal year 2025 improper payments fact sheet</a>, CMS said improper payment measurement is not a measure of fraud and that improper payments are payments that do not meet program payment requirements. CMS reported that the Medicare Fee-for-Service rate fell from 7.66 percent to 6.55 percent, the ninth consecutive year below the 10 percent statutory threshold. It attributed the higher Medicaid rate to the unwinding of flexibilities given to states during the COVID-19 public health emergency and said most Medicaid improper payments resulted from insufficient documentation, which it described as generally not indicative of fraud or abuse.

The institution’s response

CMS’s fiscal year 2025 Medicare Fee-for-Service estimate of $28.83 billion in improper payments, a 6.55 percent rate, is based on claims submitted from July 2023 through June 2024, when the federal executive branch was Democratic-led; GAO reports $186 billion in improper payments across 64 programs for fiscal year 2025. Status: improper payment estimate.



This page documents fiscal year 2025 improper-payment estimates, their program sources and their evidentiary classifications. The national record appears in <a href="https://www.tpaction.com/are-democrats-corrupt-what-the-public-record-shows-state-by-state/">Are Democrats corrupt? What the public record shows, state by state.</a>

What this shows about Democratic governance.

Last reviewed: September 11, 2026.



The public record establishes that agencies estimated $186 billion in improper payments during fiscal year 2025, including approximately $153 billion in overpayments. It also establishes that payment-error rates remained above 10 percent in numerous programs and that some agencies failed to meet every reporting requirement.



Determining the fraud component requires claim-level investigations, evidence of intent, charging decisions and final court outcomes.

What the record proves

Frequently asked questions

Arizona residents can review federal payment-integrity reports alongside state audits, court records and agency corrective-action updates. Ask whether an amount is an estimate, overpayment, questioned cost, alleged fraud loss, restitution order or confirmed recovery before repeating it. Eligible residents can also <a href="https://tpaction.com/Vote">Register to Vote</a> and use these public records when evaluating how Democratic-led institutions manage taxpayer-funded programs.



Payment accountability requires more than announcing a large estimate. Residents should track whether agencies improve eligibility verification, screen high-risk providers, prevent duplicate claims and recover confirmed losses. Arizonans can <a href="https://www.tpaction.com/plan">make a plan to vote</a> before applicable deadlines and <a href="https://www.tpaction.com/getinvolved">get involved</a> in voter education and civic efforts focused on fraud, waste, transparency and responsible government.

Review the evidence and participate

See what the federal government’s $186 billion improper-payment estimate measures across Medicare, Medicaid, SNAP, tax credits and other programs.

Improper payments vs. fraud: what the $186 billion actually measures, program by program

Key facts

What is an improper payment?

How is fraud different?

What does the $186 billion represent?

Medicare Fee-for-Service

Medicare Advantage

Medicaid

Earned Income Tax Credit

Supplemental Nutrition Assistance Program

Unemployment Insurance

Affordable Care Act premium tax credits

Which programs remained above 10 percent?

Which controls can reduce improper payments?

The institution’s response

What this shows about Democratic governance.

What the record proves

Frequently asked questions

Is this an example of Democratic corruption?

Is the $186 billion the amount lost to fraud?

Which programs had the largest improper payments?

Why did Medicaid improper payments rise in fiscal year 2025?

Review the evidence and participate

RioSlum Studio

Improper payments vs. fraud: what the $186 billion actually measures, program by program

Key facts

What is an improper payment?

How is fraud different?

What does the $186 billion represent?

Medicare Fee-for-Service

Medicare Advantage

Medicaid

Earned Income Tax Credit

Supplemental Nutrition Assistance Program

Unemployment Insurance

Affordable Care Act premium tax credits

Which programs remained above 10 percent?

Which controls can reduce improper payments?

The institution’s response

What this shows about Democratic governance.

What the record proves

Frequently asked questions

Is this an example of Democratic corruption?

Is the $186 billion the amount lost to fraud?

Which programs had the largest improper payments?

Why did Medicaid improper payments rise in fiscal year 2025?

Review the evidence and participate