Yesterday, the leadership of the Senate Finance, Energy and Commerce, and Ways and Means Subcommittee on Oversight sent a bi-partisan letter to the Comptroller of the Government Accountability Office requesting a report on the activities, methods and coordination of MAC, RAC, ZPIC and CERT audit contractors.

The Senate Finance Committee were sent many questions from AMEPA members and other stakeholders in response to a request for audit feedback from the healthcare industry in the form of white papers.

The Senators and Representatives asked the GAO to evaluate the following questions:

What process does CMS use to determine whether the contractors' audit criteria and methodologies are valid, clear and consistent? 

How does CMS coordinate among these contractors to ensure that their interactions with providers are not duplicative? Is there any evidence of providers being subjected to multiple overlapping audits on the same topic? If so, how frequently does this occur? Isthere any justification for a single provider being audited by multiple contractors at the same time?

What are the reasons for requesting that similar information be submitted to multiple contractors? Are there steps CMS is taking to limit duplicative audits, while still ensuring contractors have the tools necessary to pursue program integrity efforts?

Does CMS have a strategic plan to coordinate and oversee all of its audit activities and, if so, how is that plan implemented and overseen?

The letter was signed by the following legislators:

Senator Max Baucus (D-MT) Chair of the Senate Finance Committee

Senator Orin Hatch (R-UT) Ranking Member of the Senate Finance Committee

Senator Tom Coburn, M.D. (R-OK) Ranking Member of the Senate Finance, Subcommittee on Social Security, Pension & Family Policy

Senator Tom Carper (D-DE) Deputy Whip, Member of the Senate Finance Committee

Senator Charles Grassley (R-IA) Ranking Member of the Senate Finance, Subcommittee on Health

Representative Fred Upton (R-MI ) Chair of the Energy & Commerce Committee

Representative Henry Waxman (D-CA) Ranking Member of the Energy & Commerce Committee

Representative Cliff Sterns (R-FL) Chair of the Energy & Commerce, Subcommittee on Oversight & Investigations

Representative Diana DeGette (D-CO) Ranking Member of the Energy & Commerce, Subcommittee on Oversight & Investigations

Representative Charles Boustany, M.D. (R-LA) Chair of the Ways & Means, Oversight Subcommittee

Representative John Lewis (D-GA) Ranking Member of the Ways & Means, Oversight Subcommittee

A copy of the letter is accessible below

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