Federal spending · FY2025
Medicare
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Fetching FY2025 File B line items, totals and analysis from the backend.
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Fetching FY2025 File B line items, totals and analysis from the backend.
Fetching FY2025 File B line items, totals and analysis from the backend.
Medicare serves as the primary federal health insurance program for over 65 million Americans, including seniors and individuals with certain disabilities. Its core mission is to provide access to affordable, quality healthcare, thereby improving health outcomes and reducing financial burdens for beneficiaries. Success is measured by the program's ability to ensure access to necessary medical services, manage healthcare costs effectively, and adapt to the evolving needs of its enrollees. The Centers for Medicare & Medicaid Services (CMS) administers Medicare, overseeing its various parts (A, B, C, and D) which cover hospital stays, physician services, managed care plans, and prescription drugs, respectively. The program's financial health is paramount to the well-being of millions and the broader healthcare system.
The problem
Extra payments for health conditions without supporting medical records. CMS estimated $23.67 billion in FY2025 Medicare Advantage payment errors, mainly because medical records did not support the health conditions used to claim payments. The problem is paying extra without enough supporting evidence. This is an estimate of errors, not a total of proven fraud or stolen money. Scope: Medicare Advantage only; the displayed function also includes other Medicare programs.
The solution
Check bills against care records before paying where errors are common. Check that private Medicare plans have medical evidence for extra payments, and recover confirmed overpayments from providers or insurers. Give providers a way to challenge errors while patients keep necessary care. How this helps: Money reaches real patient care instead of unsupported bills or extra payments. Protect people: Keep necessary care available to people who qualify. Check waiting times and mistaken denials, and let people challenge errors. Measure success: correct bills, overpayments recovered, patient waiting times and mistaken denials.
Finances covered medical care through Medicare insurance programs and the administration of provider and health-plan payments.
How to read it: Tap a row to open what's inside. Colours match the chart above, and each row's share is its part of the row it sits under.
| Where it went | Gross outlays | Share | Action |
|---|---|---|---|
| $578.6B32.4% | 32.4% | ||
| $554.7B31.1% | 31.1% | ||
| $444.8B24.9% | 24.9% | ||
| $163.1B9.1% | 9.1% | ||
| $41.1B2.3% | 2.3% | ||
| $2.6B0.1% | 0.1% | ||
| $791M<0.1% | <0.1% | ||
| $195M<0.1% | <0.1% | ||
| $27K<0.1% | <0.1% | ||
| $866<0.1% | <0.1% |
From tracking spending to demanding receipts
Today’s reporting can show spending without a complete trail to the final recipient or proof of delivery. Help close those gaps, strengthen checks before payment, and reduce opportunities for fraud and abuse.
Support the Receipts & Transparency Act →Read the citizen proposal and add your support.