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CMS Oversight of Medicare Fee-for-Service Contractors - GAO Survey

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The Government Accountability Office (GAO) has reached out to VNAA to provide insight into Medicare prepayment audits on home health and hospice providers for a study they are conducting on behalf of several members of Congress.

In addition to the questions provided by GAO for the purposes of the this survey, GAO notes that some provider groups have indicated that the written correspondence from the contractors is unclear and unhelpful, especially ADR letters and Notice of Review Results. GAO would like to see examples of such letters—redacted to remove provider and any beneficiary identifiers.

VNAA needs additional information from members regarding these audits, please take a moment to review GAO's statement of purpose and answer the questions below completely as possible.

GAO Statement of Purpose:


GAO will examine CMS's oversight of four types of contractors that conduct Medicare post-payment claims reviews: Medicare Administrative Contractors, Recovery Auditors,[1] Zone Program Integrity Contractors,[2] and Comprehensive Error Rate Testing contractors. GAO is focusing its attention on the post-payment claims reviews and does not plan to address the appeals process.

[1]Recovery auditors were formerly known as recovery audit contractors or RACs.
[2]We will not examine the work of the legacy Program Safeguard Contractor that is performing post-payment audits in Zone 6.

Contact Information
Do have confusing documentation you would be willing to share including examples of unclear correspondence? All materials will be redacted to protect agencies and patients.
Can you participate in a meeting with GAO either in person or by phone on February 5?
GAO QUESTIONNAIRE: PLEASE COMPLETE AS FULLY AS POSSIBLE
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