Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Government Accountability Office GAO

GAO: CMS Erroneously Paid $16B to Medicare Advantage Orgs

July 20, 2017 - CMS incorrectly paid $16 billion to Medicare Advantage organizations (MAOs) as a result of insufficient oversight and mismanagement of data, says the Government Accountability Office (GAO) in a new report. Almost 10 percent of all MA payments were paid incorrectly even though CMS relies on risk adjustment data validation (RADV) audits to ensure correct payments to MAOs. GAO examined the CMS...


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GAO Report: VA Benefits Appeals Process in Need of Reform

by Thomas Beaton

The Government Accountability Office (GAO) has identified notable inefficiencies in the VA benefits appeals process which have resulted in an average processing wait time of three years.   In its report on the issue, GAO also makes several...

Wait Times Still High for Veterans in VA Choice Program

by Thomas Beaton

Research from the Government Accountability Office (GAO) found that veterans waited an average 24 days to receive care at any care facility that is administered by the Veterans Choice Program. The program allows veterans to receive care from...

GAO: Erroneous Medicaid Claims Data Pose Fraud Risk at CMS

by Thomas Beaton

Millions of people rely on long-term personal care services under Medicaid coverage, but significant gaps and errors in two major CMS data systems are creating significant opportunities for fraud and abuse.   A new report from the Government...

CMS Unlawfully Paid $9M to Beneficiaries for Medicare Services

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) has improperly paid more than $9 million for Medicare services among 481 unlawfully present beneficiaries during the years 2013 and 2014, according to a report from the Department of Health...

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