The CMS has made progress implementing Medicare contracting reforms, but certain decisions have led to payment delays to providers, the
Government Accountability Office concluded in a new report.
The Medicare Administrative Contractor, or MAC, program, created under the Medicare Modernization Act of 2003, was designed to improve service to providers, physicians and practitioners, while resulting in greater administrative efficiency and effectiveness for fee-for-service Medicare. A total of 19 new contracts, valued at about $4.7 billion, have been awarded over the past few years to administer the program.
The GAO found that the agency’s accelerated implementation schedule of the MAC program overlapped with other Medicare initiatives, which affected claims processing and resulted in payment delays. Additionally, the contractors themselves have not met all performance standards under the program.
The CMS planned to save money by accelerating the reforms, yet the total costs and savings to date for Medicare contracting reform could not be determined.
The report had been requested by the leaders of the Senate Finance Committee to evaluate and report on Medicare contracting reform efforts. “I am pleased to see CMS showing this initiative and moving quickly to streamline payments and reduce fraud, though, when it comes to reforming Medicare contracting, CMS needs to do a better job of improving quality and identifying ways to save money,” Sen. Max Baucus (D-Mont.), the finance panel’s chairman, said in a written statement.
