In the federal government’s latest push against Medicaid fraud and waste, the Trump administration will require all 50 states to submit plans outlining how they will revalidate high-risk providers. This heightened focus on accountability mirrors MedBen’s ongoing commitment to ensuring clients pay only for the right care at the right cost.
Medicaid’s challenges remain significant. In FY 2025, CMS reported an estimated $37.39 billion in improper payments (a 6.12% rate). State efforts such as Medicaid Recovery Audit Contractor (RAC) programs and Fraud Control Unit recoveries continue to identify and recoup billions in overpayments annually.
Closer to home, who’s watching your claims? Since 2007, MedBen’s physician-led forensic claims review has been delivering proactive, targeted protection for self-funded plans. In fact, in 2025 the program saved clients $22.38 per employee per month by identifying payment issues that often go undetected. For an employer with 500 lives, this means an annual savings of $134,280, on top of any PPO discounts.
REMINDER: The 2026 MedBen Client Report highlights forensic claims review and a variety of other proven solutions designed to promote accountability and affordability. Download your copy at MedBen.com.