United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Accounting and Information Management Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2000-03-15 monographic deposited born digital 58 p. GA 1.13:AIMD-00-66 https://www.govinfo.gov/app/details/GAOREPORTS-AIMD-00-66 P0b002ee1803a46e2 f:ai00066 DGPO 2010-08-12 2011-03-24 GAOREPORTS-AIMD-00-66 machine generated eng fdlp REPORT GAOREPORTS-AIMD-00-66 AIMD-00-66 Claims processing Internal controls Contractor violations Accountability Financial management Health insurance Reporting requirements Financial statement audits Contract oversight Federal agency accounting systems Medicare Program HCFA Integrated General Ledger Accounting System HCFA Accounts Receivable System HCFA Recovery Management Accounting System Letter Report AIMD

Although the Health Care Financing Administration (HCFA) is supposed to ensure that the billions of dollars spent on Medicare each year are managed in a fiscally responsible way, it has yet to establish adequate accountability and control over the program's financial operations. HCFA's financial management activities--from evaluation and follow-ups on audit findings to contractor monitoring and financial reporting--fall short in addressing weaknesses repeatedly cited in audits and other reviews. Unless these weaknesses are resolved, the government is at risk of substantial losses. Financial statement audits have long criticized claims contractors for internal control and financial reporting weaknesses, including failure to safeguard checks received from providers for overpayments and incorrectly recording billions of dollars owed to Medicare for such overpayments. However, HCFA's procedures for following up on audit findings and evaluating corrective actions remain insufficient. Poor monitoring of contractors' financial activities is another problem. Audit reports have also cited HCFA for inefficiencies in its internal control financial reporting practices, including a lack of documented policies and procedures. These deficiencies call into question the reliability of the data that Congress and HCFA use to track Medicare program costs and make decisions about future funding. HCFA officials have launched several initiatives to strengthen the agency's control and accountability, such as hiring outside consultants to evaluate the contractors' internal controls. However, the agency still lacks a comprehensive strategy to ensure successful implementation of these initiatives, direct financial management activities, and sustain improvements in the long term. Without such a strategy, billions of dollars will remain vulnerable to fraud and abuse and HCFA's financial management problems will likely persist. GAO summarized this report in testimony before Congress; see: Medicare Financial Management: Further Improvements Needed to Establish Adequate Financial Control and Accountability, by Gloria Jarmon, Director of Accounting and Financial Management Issues, before the Subcommittee on Government Management, Information, and Technology, House Committee on Government Reform. GAO/T-AIMD-00-118, Mar. 15 (22 pages). https://www.govinfo.gov/content/pkg/GAOREPORTS-AIMD-00-66/html/GAOREPORTS-AIMD-00-66.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-AIMD-00-66/pdf/GAOREPORTS-AIMD-00-66.pdf GAO/AIMD-00-66 https://www.govinfo.gov/app/details/GAOREPORTS-AIMD-00-66 Letter Report GAO/AIMD-00-66; Medicare Financial Management: Further Improvements Needed; Claims processing Internal controls Contractor violations Accountability Financial management Health insurance Reporting requirements Financial statement audits Contract oversight Federal agency accounting systems Medicare Program HCFA Integrated General Ledger Accounting System HCFA Accounts Receivable System HCFA Recovery Management Accounting System Title 31 Section 720 31 U.S.C. 720