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Assessment of the Usage of Bid Proposal Audits of Utilization and Quality Control Peer Review Organizations

Issued on  | Posted on  | Report number: A-14-91-00343

Report Materials

EXECUTIVE SUMMARY:

This final report points out that the Office of Inspector General's (OIG) audits of peer review organizations (PRO) bid proposals completed during Fiscal Year 1990 resulted in a savings to the Medicare program of over $33 million. This represents a return of $83 to $1 when compared with the cost of performing these audits. However, the Health Care Financing Administration (HCFA) did not have a comprehensive program to reduce the occurrences of unsupported costs in future PRO bid proposals. Further, HCFA had not taken action to ensure that PROs take appropriate actions in response to procedural recommendations made in the OIG's PRO proposal audits.

Report Type
Audit
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
-
Target Groups
-
Financial Groups
-

Notice

This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.