To no one's surprise, the Medicare program has once again been found to be especially vulnerable to fraud, waste, and abuse. The GAO has designated Medicare as a high-risk program dating back to 1990, when it published the first high-risk list, and the 2013 list tells the same story. While the GAO acknowledged that Medicare has made some improvements to program integrity, such as focusing on the improper payment error rate, more work remains.

For example, the GAO said Medicare should improve the structure of prepayment controls used by contractors to flag improper claims. Additionally, Medicare should develop and finalize schedules for IT initiatives related to reducing improper payments, and should create performance metrics to ensure that the initiatives are effective. However, if the past is prologue, don't count on Medicare being taken off the high-risk list next year.