The Obama administration is tired of seeing billions of dollars wasted on improper Medicare payments. An internal document sent in February by Office of Management and Budget Director Shaun Donovan to Health and Human Services Secretary Sylvia Burwell displays the desire by administration officials to crack down on unwarranted payments. The letter was obtained by the Center for Public Integrity through a Freedom of Information request.

“While some progress has been made on this front, we believe a more aggressive strategy can be implemented to reduce the levels of improper payments we are currently seeing,” Donovan wrote.

The federal Government Accountability Office estimated that 13 percent of all payments made for traditional Medicare last year were improper. That means a whopping $45 billion was spent that shouldn't have been.

Other public health services are certainly far from perfect. Medicaid is also a source of billions of dollars of improper payments. In acknowledgement of the challenges the government faces with its two existing health programs, Donovan warned that additional safeguards must be put in place to prevent the Patient Protection and Affordable Care Act system from being similarly abused.

As part of efforts to ensure the "integrity" of the PPACA insurance marketplace, both the Treasury Department and the Department of Health and Human Services will begin to "perform risk assessments to determine areas that might affect payment accuracy," wrote Donovan.

Attempts to rein in Medicare spending have always been a contentious issue. Efforts to achieve $716 savings in Medicare as part of the PPACA were often decried by the PPACA's opponents as stealing from Medicare to fund a new entitlement program.

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Obama administration seeks to crack down on improper Medicare payments

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