Congress asks GAO to investigate Medicare and Medicaid antifraud contractors

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Sen. Henry Waxman (D-CA)
Sen. Henry Waxman (D-CA)

Following a series of troubling reports about the success rate of antifraud contractors, lawmakers are asking the Government Accountability Office to study Medicare and Medicaid audit programs.

In a letter to GAO Comptroller Gene L. Dodaro, a bipartisan group of lawmakers, including Sen. Tom Coburn (R-OK), Rep. Henry Waxman (D-CA), asked the GAO to investigate coordination among contractors and efficiency within the program. A recent GAO report found that the Centers for Medicare & Medicaid Services spent $102 million on Medicaid audit programs that only recovered $20 million in overpayments.

“In order for this contractor oversight to be at once 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,” the letter states.

There are several antifraud contractors within Medicare and Medicaid, including Recovery Audit Contractors, Zone Program Integrity Contractors, and Medicare Administrative Contractors.

Click here to read the full letter.