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The GAO prepared this report under the authority of the Comptroller General to conduct work on GAO's initiative to assist Congress with its oversight responsibilities for the Medicaid program. In this report, the GAO provides information on: (1) the extent to which state Medicaid programs vary the rates paid to providers for a given service and the basis for the variation; and (2) the extent to which Medicaid provider payment rates calculated from claims data confirm rates reported in studies of states' fee schedules.