GAO labels Medicaid auditing process 'inefficient'

Monday, December 10, 2012

WASHINGTON – The Medicaid Integrity Group’s (MIG’s) hiring of separate review and audit contractors was “inefficient and led to duplication because key functions were performed by both entities,” according to a new study by the Government Accountability Office (GAO). Because both types of contractors had to determine whether payments were improper under state Medicaid policies, it doubled the burden of states in ensuring that policies were correctly applied. The GAO recommends that CMS eliminate duplication by merging contractor functions, using comprehensive reviews to better target audits, and following up with states to ensure reliable reporting of their program integrity recoveries.

For more information on the study, click here.