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 2001-10-09 monographic deposited born digital 40 p. GA 1.13:GAO-02-33 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-02-33 P0b002ee1803a1493 f:d0233 DGPO 2010-08-12 2011-03-24 GAOREPORTS-GAO-02-33 machine generated eng fdlp REPORT GAOREPORTS-GAO-02-33 GAO-02-33 Health care costs Health care facilities Health care programs Managed health care Medicare Choice Program Adjusted Community Rate Proposal Other Written Product A02222 The Centers for Medicare and Medicaid Services (CMS), spent about $35 billion dollars in 2000 on Medicare+Choice, Medicare's managed care alternative to its fee-for-service program. During this time, almost 6.3 million Medicare beneficiaries were enrolled in health plans offered by managed care organizations (MCO) that participate in the Medicare+Choice program. Annually, a MCO choosing to participate in the Medicare+Choice program must submit an Adjusted Community Rate Proposal (ACRP) for each plan that it intends to offer to CMS for its review and approval. The ACRP identifies the health services the MCO will provide to its Medicare members and the estimated cost of providing those services. It also shows the estimated payments that the MCO expects to recieve for providing these services. This report shows that overall, CMS' approach in the first year met the Balanced Budget Act of 1997 (BBA) requirements, and lays the foundation for future years audit process. Also in 2000 the Department of Health and Human Services' Office of Inspector General (HHS OIG) and three CPA firms conducted the audits in accordance with generally accepted auditing standards (GAAS) and generally followed CMS' audit program, including submission of audit reports detailing their findings. However, the audit reports were not always complete or consistently prepared. CMS has now hired a contractor to re-evaluate certain contract year 2000 audit reports in which possible overcharges were identified https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-02-33/html/GAOREPORTS-GAO-02-33.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-02-33/pdf/GAOREPORTS-GAO-02-33.pdf GAO-02-33 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-02-33 Other Written Product GAO-02-33; Medicare + Choice Audits: Lack of Audit Follow-up Limits Usefulness; Health care costs Health care facilities Health care programs Managed health care Medicare Choice Program Adjusted Community Rate Proposal Title 42 Chapter 7 42 U.S.C. Chapter 7 Volume 96 Page 324 96 Stat. 324 Volume 111 Page 251 111 Stat. 251 Public Law 97-248 Public Law 105-33