Medicaid: CMS oversight and guidance could improve Recovery Audit Contractor program : report to congressional requesters
- Collection:
- Health Policy and Services Research
- Alternate Title(s):
- CMS oversight and guidance could improve Recovery Audit Contractor program: report to congressional requesters
- Contributor(s):
- United States. Government Accountability Office, issuing body.
- Publication:
- Washington, DC : United States Government Accountability Office, June 2023
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Contract Services -- legislation & jurisprudence Financial Audit -- legislation & jurisprudence Government Regulation Legislation, Medical Medicaid -- legislation & jurisprudence United States Medicare Recovery Audit Contractor Program (U.S.)
- Genre(s):
- Technical Report
- Abstract:
- Why GAO did this study. Medicaid has been on GAO’s High Risk List since 2003, in part due to concerns about the adequacy of fiscal oversight. GAO was asked to review the Medicaid RAC program. This report (1) describes the status of states’ use of the program, (2) evaluates CMS’s oversight of states’ Medicaid RAC programs, and (3) evaluates any opportunities for CMS to improve the program. To do so, GAO analyzed statutes, regulations, policies, guidance, and CMS reports related to recovery audit contractors. GAO examined certain documents covering the Medicaid RAC program for all states and the District of Columbia, during fiscal year 2021 and interviewed CMS and state officials from a nongeneralizable sample of 11 states. What GAO recommends. GAO is making four recommendations, including that CMS establish and implement written policies and procedures to document and communicate an expiration date for full exemption from the Medicaid RAC program, and conduct a cost-effectiveness study to determine whether states should include payments to managed care organizations as part of the program. CMS concurred with two, partially concurred with one, and disagreed with one of GAO’s recommendations. GAO continues to believe that all of the recommendations are warranted.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (ii, 26 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918681586706676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918681586706676