The 68-page report examines CMS’s transition to six MACs, as of March 2009. The GAO found that some of CMS’s decisions during the roll-out resulted in delays in claims processing, including an accelerated implementation schedule that overlapped with other Medicare initiatives. The report also found that CMS provided MACs with inaccurate workload estimates, which led to delayed payments and backlogs.
CMS did incorporate lessons learned and made midcourse adjustments to address some of these challenges, according to the report. The agency assessed its program and found that none of the MACs met all of the standards and metrics in its assessment program. However, three of the six MACs in the GAO’s sample did improve their overall performance, but still failed to meet all metrics. For example, while the three MACs consistently met or partially met a metric that assesses contract management, they did not meet some beneficiary and provider service metrics, according to the report.
An accurate report of costs and savings to date for Medicare contracting reform is not available as CMS does not track and/or provide information on all related costs and savings, according to the report.
Read the summary of the GAO’s report on Medicare contracting reform.
