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Medicare Administrative Contractor Cost Report Oversight - Contract Review

In accordance with their CMS contracts, Medicare administrative contractors (MACs) are responsible for accepting, auditing, and settling provider Medicare cost reports. The MAC performs desk reviews of all cost reports and audits as warranted prior to settlement of the cost report to determine adequacy, completeness, and accuracy and reasonableness of the data in the cost report. We will review the MACs cost report oversight by verifying the number of desk reviews and the number of audits performed in accordance with the CMS contract and identify non-compliance issues. Following this review, we will conduct additional reviews that will include MAC audit findings and recommendations to determine whether the provider implemented the recommendations and took corrective action. Finally, we will examine CMS's oversight of the MAC cost report desk reviews/audits. Our audit's objective is to determine whether the individual MACs met requirements stated in the MAC contracts.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Revised Centers for Medicare and Medicaid Services Medicare Administrative Contractor Cost Report Oversight - Contract Review Office of Audit Services W-00-22-35881 2024