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Members of the Senate and House today requested a Government Accountability Office study of the anti-fraud audits conducted by the Medicare program to identify and eliminate fraud and improper payments.  Private contractors play an important role in Medicare’s fraud and improper payment prevention effort.  The requested study focuses on the coordination and effectiveness of the anti-fraud work conducted by these contractors. The members wrote:

“Health care providers are responsible for interacting with, and responding to, each of these contractors.  In order for this contractor oversight to at once be effective at detecting improper payments and not unnecessarily burdensome to providers, it must be undertaken subject to a coherent strategic plan, consistent standards and active coordination.

“To this end, we ask that you undertake a study that focuses on coordination among contractor efforts and CMS efforts to oversee these contractors to ensure that they are working efficiently and effectively while guaranteeing that beneficiaries are receiving care to which they are entitled.”

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