GAO Criticizes Medicare Part D Recovery Audits
Posted on Wednesday, September 16, 2015 2:12 PM
A new report from the U.S. Government Accountability Office (GAO) shows the Medicare Part D recovery audit contractor needing drastic improvements.
From January 2011 to May 2015, the Medicare Part D RAC recovered less than $10 million in improper payments, according to the GAO. This small amount could be due to difficulties between the RAC and CMS in deciding which issues warranted an audit. According to the report, CMS approved just one of the 15 audit proposals from the RAC since 2011.
CMS has not started an annual evaluation of the Part D RAC since it was first implemented, although the evaluation for 2014 is pending.
The GAO recommends CMS to set clearer expectations in contract work statements, conduct annual RAC performance evaluations, and review the process for approving audit proposals as it beings to solicit the next RAC contracts.
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