Medicare Transaction System: Strengthened Management and Sound
Development Approach Critical to Success (Testimony, 11/16/95,
GAO/T-AIMD-96-12).

GAO discussed the Health Care Financing Administration's (HCFA) approach
to managing the Medicare Transaction System (MTS). GAO noted that: (1)
MTS is designed to unify the nine Medicare claims-processing systems,
improve Medicare contractor oversight, improve services to beneficiaries
and providers, reduce administrative expenses, and better protect
Medicare program funds from waste, fraud, and abuse; (2) although HCFA
plans to mitigate large scale problems by implementing MTS in increments
and design MTS to allow for future modifications, the lack of an
effective management approach exposes the system to undue risks; (3)
HCFA has not adequately defined MTS project requirements, has not
identified significant system-development overlap, and lacks reliable
cost and benefit information; and (4) HCFA could substantially reduce
MTS development risks by implementing some of the best practices that
have been proven effective in other organizations, such as changing HCFA
information management practices, creating line manager ownership,
better managing MTS resources, and measuring MTS project performance.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  T-AIMD-96-12
     TITLE:  Medicare Transaction System: Strengthened Management and 
             Sound Development Approach Critical to Success
      DATE:  11/16/95
   SUBJECT:  Risk management
             Information resources management
             Claims processing
             Delivery terms
             Computerized information systems
             Strategic information systems planning
             Requirements definition
             Medicare programs
             Systems evaluation
IDENTIFIER:  HCFA Medicare Transaction System
             FAA Advanced Automation System
             IRS Tax System Modernization Program
             TSM
             
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