Every Medicaid dollar should come with accountability: Was the beneficiary eligible? Was the service authorized and delivered? Did the spending accomplish its purpose? Taxpayers deserve answers. So do the patients whose care depends on the program.

The administration has made a bold promise to prioritize rooting out fraud, waste, and abuse, with notable progress already. Every dollar stolen, improperly paid, or needlessly spent is a dollar unavailable for legitimate patient care for our most vulnerable citizens. Protecting Medicaid’s resources is essential to protecting the people the program was created to serve.

But accountability cannot begin only after the money is gone. We can all agree the status quo “pay and chase” model is ineffective. Instead, we need systems designed to confirm eligibility, prevent improper payments, document services, and identify problems before they become expensive failures.

That requires modernization with a clear purpose: stronger safeguards, better information, and measurable results.

Eligibility verification is one part of that work. States should have accurate, timely information to determine who qualifies for coverage and resolve discrepancies promptly. Payment oversight is another. States should be able to verify provider qualifications, identify questionable billing, and establish whether an authorized service was actually delivered.

Care coordination addresses a related problem: spending that fails to produce the high-quality, community-based services patients need. Services........

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