You could put this story under the category of “Tell Me Something I Don’t Already Know.”

But, nonetheless, the Government Accountability Office (GAO) has come across what all of us know all ready: too many audit contractors and too much overlap. The July report from the GAO will be discussed next Monday on Monitor Monday. 

Here is what the GAO perceives the problem as stated in the agency’s July report:

“Recently, questions have been raised about the efficiency and effectiveness of these contractors’ efforts and the administrative burden on providers. This report (1) describes these contractors and (2) assesses the extent to which requirements for postpayment claims reviews differ across the contractors and whether differences, if any, could impede effective and efficient claims reviews. GAO reviewed CMS’s requirements for claims reviews in manuals and contracts, interviewed CMS officials and selected provider associations, and assessed the requirements against internal control standards and executive-agency guidance on streamlining service delivery. GAO also obtained data on numbers of claims reviewed, and appealed.

And here are steps the GAO is recommending to CMS, again, from the report:

GAO recommends that CMS
(1) examine all contractor postpayment review requirements to determine those that could be made more consistent, (2) communicate its findings and time frame for taking action, and (3) reduce differences where it can be done without impeding efforts to reduce improper payments. In its comments, the Department of Health and Human Services concurred with these recommendations, agreed to reduce differences in postpayment review requirements where appropriate, and noted that CMS had begun examining these requirements.

As we used to say in TV News: “Film at 11.”

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