HHS OIG Issues Report on MAC Inadequacies
Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued a report on the inadequate oversight efforts of Medicare Administrative Contractors (MACs).
Medicare Administrative Contractors Did Not Consistently Meet Medicare Cost Report Oversight Requirements (A-04-22-06264)
Medicare cost reports are a crucial component of the operation and oversight of the Medicare program. Cost reports are used to set future Medicare prospective payment rate and wage indexes and reimburse providers for the care that the facilities provide to Medicare enrollees. Medicare Administrative Contractors (MACs) did not consistently meet Medicare cost report oversight requirements. For Federal Fiscal Years 2019–2021, each of the 12 MAC jurisdictions failed to comply with the contract requirements for audit and reimbursement desk review and audit quality for at least 1 of the 3 years. The Centers for Medicare and Medicaid Services identified 287 total audit issues among all MAC jurisdictions during our audit period, including MACs not performing proper reviews, improper calculation and reimbursement for nursing and allied health programs, and inadequate review of bad debts.
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