Corrective Action Review of the Health Care Financing Administration's Medicare Payment Safeguards Program

EXECUTIVE SUMMARY:

This final report provides the results of our corrective action review of the Medicare payment safeguards program which was requested by the Department of Health and Human Services' Council on Management Oversight. We found that the Health Care Financing Administration maintained relatively stable payment safeguard funding levels as stated in their corrective action plan. However, we found that these funding levels were not adequate for contractors to maintain consistent staffing and workload activity in the safeguard areas of Medicare secondary payer and medical and utilization review.