United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2000-06-30 monographic deposited born digital 19 p. GA 1.13:HEHS-00-135R https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-00-135R P0b002ee18039e9a4 f:he00135r DGPO 2010-08-12 2011-03-23 GAOREPORTS-HEHS-00-135R machine generated eng fdlp REPORT GAOREPORTS-HEHS-00-135R HEHS-00-135R Claims processing Program abuses Fraud Health insurance Internal controls Reporting requirements Contractor personnel Cost analysis Medicare Program Medicare Integrity Program Correspondence HEHS Pursuant to a congressional request, GAO provided information on the use of employee screening measures by Medicare claims administration and program safeguard contractors, focusing on the: (1) requirements the Health Care Financing Administration (HCFA) has placed on Medicare contractors to conduct employee background checks; (2) steps Medicare contractors are taking to ensure that employees are trustworthy in handling Medicare funds and sensitive information; and (3) costs to Medicare contractors of conducting background checks or using other employee screening measures.<p/>GAO noted that: (1) HCFA expects its contractors to exercise sound business judgment when they make hiring decisions; (2) as a result, HCFA does not specifically require its Medicare claims administration and program safeguard contractors to conduct background checks or undertake other employee screening measures; (3) however, HCFA does advise its claims administration contractors to adopt personnel selection safeguards, specifically employment verification and applicant certifications; (4) HCFA also requires its claims administration contractors to obtain fidelity bonds for certain employees; (5) in addition, both Medicare claims administration and program safeguard contractors are required to collect and submit to HCFA conflict of interest information; (6) the Medicare claims administration and program safeguard contractors GAO surveyed screen their employees as common business practice without specific requirements from HCFA to do so; (7) nearly all the contractors in GAO's sample said that they perform typical screening measures, such as employment and education verification, reference checking, and credential validation; (8) most of the claims administration contractors GAO spoke to also reported that they perform more extensive screening measures, such as criminal background checks and drug tests; (9) in contrast, the two program safeguard contractors GAO surveyed indicated that they do not conduct criminal background checks or require drug testing unless such requirements are included in their contracts; (10) both claims administration and program safeguard contractors reported that they rarely use less traditional screening measures, such as credit checks and government debarment and exclusion database reviews; (11) the costs associated with employee screening vary by the complexity and urgency associated with each screening measure; (12) however, the Medicare contractors GAO surveyed could not calculate the total cost of their employee screening measures; and (13) the fact that employee screening efforts are conducted and continue to be recognized as a common business practice within the Medicare contractor community suggests that such measures are considered worthwhile. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-00-135R/html/GAOREPORTS-HEHS-00-135R.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-00-135R/pdf/GAOREPORTS-HEHS-00-135R.pdf GAO/HEHS-00-135R https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-00-135R Correspondence GAO/HEHS-00-135R; Medicare: Contractors Screen Employees but Extent of; Claims processing Program abuses Fraud Health insurance Internal controls Reporting requirements Contractor personnel Cost analysis Medicare Program Medicare Integrity Program