GAO Report: CMS Not Adequately Addressing Payment System Issues
CMS has not taken steps to address many sytemic issues that resulted in $231 million in improper Medicare payments, according to a report released last week by the Government Accountability Office, HealthLeaders Media reports.
In March 2008, CMS ended a three-year demonstration project to determine if recovery audit contractors could detect improper Medicare payments and recoup overpayments. The contractors identified $231 million in overpayments, many of which were for duplicate claims.
However, the GAO report found that CMS has not yet taken corrective action on about 60% of the system vulnerabilities that resulted in the improper payments.
The report also noted that it took CMS nearly two years to start examining the most significant vulnerabilities that resulted in improper payments.
The GAO report recommended that the CMS administrator develop and implement policies and procedures so that the agency swiftly evaluates the contractors' findings and decides on an appropriate response and timeframe for taking corrective action.
The report also recommended that CMS give certain staff the authority to ensure that such actions are being implemented when claim payment vulnerabilities are identified (Clark, HealthLeaders Media, 4/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.