Lawmakers Push GAO to Examine CMS Audits

Leading Sens. and Reps. call for an examination into ‘duplicative efforts’ of Medicare audit contractors.

Leaders and ranking members from multiple Senate and House committees and subcommittees sent a letter this week to Gene Dodaro, comptroller of the Government Accountability Office, calling for a report on activities and methods employed CMS’s MAC, RAC, ZPIC and CERT audit contractors, as well as how CMS coordinates with these auditors.

The full letter is available at https://www.box.com/s/1b572ddf578a51c62dca

In their letter, the lawmakers ask the GAO to study several issues:

  • The process CMS uses to determine if audit contractors’ methods are “valid, clear and consistent.”
  • How CMS coordinates with these contractors to ensure their efforts aren’t duplicated; whether or not providers are suffering overlapping audits; and how frequently this happens.
  • The reasons for multiple auditors asking for the same or similar information.
  • What is CMS’s plan for coordinating all these efforts in order to prevent duplicate efforts, and if the plan exists how is it being implemented.

The lawmakers signing the letter:

Sen. Max Baucus (D-Mont.) Chair of the Senate Finance Committee
Sen. Orin Hatch (R-Utah) Ranking Member of the Senate Finance Committee
Sen. Tom Coburn, M.D. (R-Okla.) Ranking Member of the Senate Finance, Subcommittee on Social Security, Pension & Family Policy
Sen. Tom Carper (D-Del.) Deputy Whip, Member of the Senate Finance Committee
Sen. Charles Grassley (R-Iowa) Ranking Member of the Senate Finance, Subcommittee on Health
Rep. Fred Upton (R-Mich) Chair of the Energy & Commerce Committee
Rep. Henry Waxman (D-Calif.) Ranking Member of the Energy & Commerce Committee
Rep. Cliff Sterns (R-Fla.) Chair of the Energy & Commerce, Subcommittee on Oversight & Investigations
Rep. Diana DeGette (D-Colo.) Ranking Member of the Energy & Commerce, Subcommittee on Oversight & Investigations
Rep. Charles Boustany, M.D. (R-La.) Chair of the Ways & Means, Oversight Subcommittee
Rep. John Lewis (D-Ga.) Ranking Member of the Ways & Means, Oversight Subcommittee

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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