Report: Providers Face Unfair Burdens Due To CMS’ Poor Auditor Oversight

According to a new report from the U.S. Government Accountability Office (U.S. GAO), long term care and other providers could be facing unfair burdens because of ineffective government oversight of Medicare auditors. Although CMS does keep a database to track Recovery Audit Contractor activity to prevent them from reviewing the same claim multiple times, the three other types of auditors do not enter information consistently into this database. Currently, CMS does not have reliable data nor does it “provide sufficient oversight and guidance to measure and fully prevent duplication,” according to the report. Inappropriate duplication of reviews can become a burden to both providers and contractors. In addition, lack of coordination among auditors can lead to other problems. The U.S. GAO recommends CMS take steps to “tighten oversight of contractors and simplify their compliance.”

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