How the Federal Government Misses Billions in Improper Payments

The Fiscal Policy Podcast with Fexingo: Government Budgets, Stimulus, and Public Spending · Aug 3, 2026 · 8m · transcript

Every year, the federal government makes hundreds of billions of dollars in improper payments — overpayments, underpayments, and payments that never should have happened. In this episode, we break down the scale of the problem, why it persists despite decades of reform, and what the latest data from fiscal year 2025 reveals. We look at the biggest culprits, from Medicare and Medicaid to unemployment insurance, and explore the structural reasons why the government hasn't been able to fix this. We also discuss the role of the Payment Integrity Information Act and what it actually requires…