GAO Says VA Community Care and Medicare Advantage Need Stronger Payment Controls
A new Government Accountability Office report says the Department of Veterans Affairs and Medicare Advantage need additional steps to reduce improper-payment and fraud risks.
The Government Accountability Office said the Department of Veterans Affairs and the Medicare Advantage program need additional actions to reduce the risk of improper payments and fraud.
GAO publicly released the report Tuesday, July 21, 2026. Titled Program Integrity: Actions Needed to Reduce Improper Payment and Fraud Risks in VA Community Care and Medicare Advantage, the review examines controls in two major federal health-payment programs.
The report identifies steps needed to strengthen program integrity, the systems and safeguards used to help ensure that federal funds are paid properly and protected from misuse.
What the report covers
The review covers VA Community Care and Medicare Advantage. VA Community Care is a Department of Veterans Affairs program, while Medicare Advantage is a federal health coverage program. Together, the programs involve payments connected to care for veterans and Medicare beneficiaries.
GAO’s central finding is that additional actions are needed to reduce improper-payment and fraud risks in both programs. The finding is about the strength of controls and oversight. It is not, by itself, a finding that every payment identified in the review was fraudulent or that a particular person or organization committed fraud.
Improper payments can include payments that should not have been made, payments made in the wrong amount or payments made to the wrong recipient. The report’s stated focus is reducing those risks through stronger program-integrity measures.
Why it matters
The programs involve federal health spending, so weaknesses in payment controls can affect more than agency accounting. They can expose taxpayer-funded programs to payments that are not supported, not accurate or otherwise improper. Stronger controls are intended to reduce that exposure and help federal agencies safeguard public funds.
The potential consequences extend to the people who rely on the programs. Veterans and Medicare beneficiaries are connected to the health services financed through these systems, while taxpayers support the federal spending behind them. A control problem can therefore raise questions about both the protection of public money and the reliability of program administration.
GAO is the audit and investigative agency of the U.S. Congress. Its work includes audits, evaluations and investigations of federal programs. The new report is part of that broader federal oversight role and places VA Community Care and Medicare Advantage in the same program-integrity review.
What happens next
The report’s release makes the need for stronger controls public, but it does not itself change how either program operates. Further action would depend on the Department of Veterans Affairs and the Medicare Advantage program addressing the actions identified by GAO.
The report provides a federal oversight assessment of improper-payment and fraud risks. It does not establish that the recommended actions have been implemented. The next meaningful step is whether the agencies adopt stronger safeguards and demonstrate that those safeguards reduce the risks identified in the review.
For veterans, Medicare beneficiaries and taxpayers, the issue is whether federal health payments are made accurately and protected from fraud. GAO’s July 21 report puts that question before the agencies responsible for the programs and Congress, which uses the Government Accountability Office’s audits and investigations to oversee federal operations.
Sources
- Auditing and Financial Management — Recent Reports, U.S. Government Accountability Office
- U.S. Government Accountability Office
