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Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2014

Federal law requires that each Medicare administrative contractor (MAC) have its information security program evaluated annually by an independent entity, and these evaluations must address the eight major requirements enumerated in the Federal Information Security Management Act of 2002 (FISMA). To comply with this provision, CMS contracted with PricewaterhouseCoopers (PwC) to evaluate information security programs at the MACs, using a set of agreed-upon procedures. To satisfy the requirement to evaluate the information security controls for a subset of systems, CMS expanded the scope of its evaluations to test segments of the Medicare claims processing systems hosted at the Medicare data centers, which support each of the MACs.

The Office of Inspector General must submit to Congress an annual report on the results of these evaluations, to include assessments of their scope and sufficiency. This report fulfills that responsibility for fiscal year 2014.

The scope of the work and sufficiency of documentation for all reported gaps were sufficient for the nine MACs reviewed by PwC. The total number of gaps identified at the MACs increased from the previous year. Deficiencies remain in all of the FISMA control areas tested, including high- and medium-risk gaps repeated from the previous year. CMS should continue its oversight visits and ensure that the MACs remediate all high- and medium-risk gaps in a timely manner. CMS provided a technical comment, which we addressed. CMS had no other comments on the draft report.

Copies can also be obtained by contacting the Office of Public Affairs at

Download the complete report.

Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201