The Hill: Report: Medicare agency not doing enough to stop duplicate audits

The Centers for Medicare and Medicaid Services (CMS) must do a better job of ensuring its auditors aren’t conducting duplicate reviews of payments to healthcare providers, according to the Government Accountability Office.

While the CMS has improved its oversight of contractors, the accountability office said the agency still can’t reliably ensure that payments aren’t reviewed twice.

“CMS requires its contractors to include certain content in postpayment review correspondence with providers, but some requirements vary across contractor types and are not always clear, and contractors vary in their compliance with their requirements,” said the report.

Lawmakers in both parties have criticized the CMS for not doing a better job of making sure providers are not being penalized for minor administrative mistakes or reviewed for the same issue by multiple auditors.

In particular, they have been highly critical of the Recovery Audit Contractor program, which lawmakers have said is threatening to put some healthcare providers out of business because of lengthy and frivolous investigations.

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  • LAAAC is managed by St. Barnabas Senior Services; Funded, in part, by Archstone Foundation.
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