OIG: Medicare Program Safeguard Contractors have "minimal" results
Healthcare Auditing Weekly, July 24, 2007
An OIG audit of Medicare's program safeguard contractors (PSCs) found a substantial difference between the number of new investigations/case referrals and law enforcement.
Some PSCs had minimal activity in these primary workload categories, according to the audit. Neither the size of a PSC's budget nor its oversight responsibility (dollar amount of Medicare paid claims) was strongly correlated with the number of new investigations nor the number of new case referrals produced in 2005.
The OIG also found that most PSCs had minimal results from proactive data analysis. In addition, the OIG found no consistency across PSCs regarding the level of detail about proactive data analysis included in the monthly status reports.
In its audit, the OIG recommended that CMS review PSCs with especially low volumes of activity in investigations and case referrals for Medicare Parts A and B. CMS should additionally require PSCs to provide more detailed explanations of their investigations, case referrals to law enforcement, and proactive data analysis activities in their monthly reports.
View the full OIG report here.
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