GAO Report on Medicare Contracting Reform
The GAO has issued a report entitled “Medicare Contracting Reform: Agency Has Made Progress with Implementation, but Contractors Have Not Met All Performance Standards.” The report discusses CMS’s transition of claims administration from carriers and fiscal intermediaries to 19 new Medicare Administrative Contractors (MAC), 15 of which will process both Part A and B Medicare claims (A/B MACs) and four that process durable medical equipment (DME) claims. CMS expects to complete the transition process ahead of the October 1, 2011 Medicare Modernization Act (MMA) deadline. The GAO found that contractor transitions to date have lead to a variety of challenges for providers, including payment delays, in part because CMS’s accelerated implementation schedule overlapped with other Medicare claims processing initiatives, including a requirement that providers re-enroll. The GAO also reports that some MACs did not meet all provider service metrics, including superior performance related to accuracy of responses to providers, claims processing timeliness, and appeals.
