Medicare and Medicaid are still at high risk of fraud and abuse and mismanagement, despite some oversight improvements, the Government Accountability Office recently reported.
One trouble spot remains nursing home inspections. The Centers for Medicare & Medicaid Services has not implemented “a more rigorous inspection process” for nursing homes “that is critical to ensuring the annual inspections do not overlook serious quality-of-care problems,” according to the GAO.
Other problems include “weaknesses” in CMS’s information security controls. CMS call centers also provided inaccurate and incomplete information to beneficiaries about the Part D drug benefit, the GAO said. Medicare has been designated a high-risk program since the listing began in 1990; Medicaid has been on the list since 2003, the January report said.
