United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2001-05-18 monographic deposited born digital 26 p. GA 1.13:GAO-01-616 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-616 P0b002ee18038efea f:d01616 DGPO 2010-08-12 2011-03-23 GAOREPORTS-GAO-01-616 machine generated eng fdlp REPORT GAOREPORTS-GAO-01-616 GAO-01-616 Fraud Health care programs Program abuses Internal controls Health insurance Contract performance Performance measures Program evaluation Medicare Program Other Written Product A00878 The Health Care Financing Administration (HCFA) chose 12 claims administration contractors in 1999 to act as program safeguard contractors (PSC) for Medicare. This report examines (1) HCFA's progress in implementing its PSC contracting authority and (2) whether HCFA could better manage of the PSCs to ensure their most effective use. GAO found that HCFA is experimenting with different options for integrating the PSCs into Medicare's program safeguard activities. Between September 1999 and March 2001, HCFA issued 15 task orders that include different ways of using PSC services. HCFA lacks a long-term strategy to determine how best to use the PSCs. Instead, it has issued task orders in an ad-hoc manner, which has afforded HCFA certain flexibilities, such as targeting its task orders on known problem areas. Although this experimental approach may be prudent in the short-term, it does not represent a process for systematically testing different options for using PSC services in the long-term. Also HCFA has not set formal criteria and timeframes for determining how the PSCs should be integrated into Medicare's existing program integrity efforts. Finally, HCFA has not established clear, measurable performance criteria to assess the PSCs' performance on individual task orders. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-616/html/GAOREPORTS-GAO-01-616.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-616/pdf/GAOREPORTS-GAO-01-616.pdf GAO-01-616 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-616 Other Written Product GAO-01-616; Medicare: Opportunities and Challenges in Contracting for Program Safeguards; Fraud Health care programs Program abuses Internal controls Health insurance Contract performance Performance measures Program evaluation Medicare Program Public Law 104-191