Improper payments totaling more than $1 billion are being spent thanks to negligent U.S. Office of Personnel Management (OPM) oversight of service providers participating in the nation’s biggest employer-provided health insurance program, the Federal Employees Health Benefits Program (FEHBP).

Authors of a new analysis by the Government Accountability Office (GAO) — the investigative arm of Congress — reported they “identified FEHB claims from approximately 400 providers who were deceased and over 2,000 additional claims from providers who were excluded from federal programs. While such claims are a small proportion of annual FEHB claims, they represent a risk the agency could mitigate. Taking additional steps to identify providers who are deceased or excluded from other federal programs would help … prevent fraud and improper payments in the FEHB program.”

The FEHBP provides health care insurance to more than 8.2 million active and retired federal civil servants and family members at an annual cost to taxpayers in excess of $70 billion, making it one of the federal government’s most costly benefits programs.

The latest GAO analysis of OPM efforts regarding improper payments was requested by Senator Ron Johnson (R-Wis.), chairman of the Permanent Subcommittee on Investigations of the Senate Committee on Homeland Security and Governmental Affairs, and panel member Rick Scott (R-Fla.).

The present GAO report did not provide a current overall estimate of the total annual cost of OPM/FEHBP improper payments — including both disbursements larger than warranted and those that should not have been issued at all such as those made to dead recipients. But the report noted that its 2022 analysis put the annual cost at more than $1 billion annually.

The stinging assessment of OPM’s efforts to prevent improper payments in FEHBP comes as evidence accumulates that the federal government’s losses to such spending are even greater than GAO and other respected sources have stated in recent years. Earlier this week, for example, GAO reported that improper payments under Medicare and Medicaid increased by $24 billion in 2025.

Those improper payments by the two largest federal health care programs were among a total of $186 billion for 64 separate programs administered by the federal government and examined by GAO. That total for 2025 represents a $24 billion increase over the 2024 total of $162 billion. The increase of improper payments came despite the greatly heightened official and public focus on the issue, thanks to President Donald Trump, billionaire entrepreneur Elon Musk, and the then-newly formed Department of Government Efficiency (DOGE).

The FEHBP total may also be significantly higher now than previously estimated because GAO has submitted multiple recommendations for needed reforms since 2022 but OPM officials during the Biden administration all but ignored the congressional agency’s detailed suggestions.

“In July 2025, we found that OPM’s fraud risk assessment did not include fraud risks related to ineligible providers in the FEHB program. We recommended that the agency design and conduct a robust fraud risk assessment that will identify inherent fraud risks facing the FEHB program, including the risk of ineligible providers. Fraud in the FEHB program can affect the government, members, and health insurance carriers by increasing program costs and posing a risk to member health,” the report said.

“As of January 2026, all six recommendations we made to OPM remain open. Furthermore, in December 2022, we also found that OPM estimated improper payments associated with ineligible family members could cost the FEHB program up to approximately $1 billion per year. We made four recommendations to improve OPM’s monitoring and assessment of fraud and improper payment risks. As of January 2026, OPM has implemented two of the four recommendations we made in 2022,” the report explained.

Among the many examples described by GAO of the failure of OPM officials managing the FEHBP, one involved a health care provider who “specialized in family medicine” and who “died in February 2022. However, a carrier continued paying [FEHBP] funds for services that were supposed rendered at least 50 days after the provider’s death. This included 58 claims attributed to the deceased provider involving services rendered up to 324 days after the provider’s death. At the time of GAO’s documentation request in January 2025, the carrier appeared to be unaware of the provider’s death.”

In another example, the GAO report noted that senior officials during the Biden era turned over much of OPM’s FEHBP anti-fraud responsibilities to the agency’s Inspector General (IG). The OPM IG maintains “a list of roles that should be disbarred,” but which, GAO said, “are not on the OPM IG’s suspension and disbarment list.” The GAO identified more than 300 entries whose specialty role is “Pharmacy Technician … more than 250 entries whose specialty role is ‘Home Health Agency,’ and more than 70 entries whose specialty role is ‘Physician Assistant.’”

Nobody at OPM could satisfactorily explain why the entries were not on the suspension and debarment list, according to GAO.

Following Trump’s election and inauguration to a second term in the Oval Office, OPM was deeply involved in the new chief executive’s campaign to reduce the federal civil service workforce by 75,000 positions via a special retirement offer. Even so, Trump’s choice as Director of OPM, Scott Kupor, has pushed agency managers to implement GAO recommendations.

“During our review, OPM OIG officials indicated they were drafting updates to their suspension and debarment guidelines for carriers and, as of December 2025, were unsure when they would finalize these guidelines. A senior OPM OIG official said they anticipated so issuing the updated guidelines after incorporating potential changes based on our review. Specifically, the officials said they would explore potential language to clarify that carriers must notify patients, regardless of whether claims are denied for reasons other than a provider’s suspension or debarment,” the GAO report pointed out.

Scott told The Washington Stand the new GAO analysis “confirms what many of us have known for years — FEHB is wasting taxpayer dollars at an alarming rate and is in need of serious reforms. Federal funds do not belong to Congress or the Executive Branch; they belong to the American people. Florida taxpayers work way too hard to have a single cent of their money wasted on improper payments and fraud.”

The Florida Republican lawmaker also noted “the One Big Beautiful Bill Act included my language to address the problems in the prior GAO report of ineligible spouses and dependents receiving benefits. That fix will save over $2 billion. Next, we need to fix the problem of ineligible providers, such as incarcerated, debarred, or dead providers billing for services. President Trump is working overtime to fight fraud and protect American taxpayers; Congress needs to be doing the same.”

A spokesman for Johnson could not be reached for comment and a spokesman for OPM’s Kupor declined to comment.