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Diane Publishing Books
Medicare Administrative Contractors: CMS Should Consider Whether Alternative Approaches Could Enhance Contactor Performance
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Kathleen M. King (au)
The Medicare Prescription Drug, Improvement, and Modernization Act of 2001 (MMA) required the Centers for Medicare & Medicaid Services (CMS) to select claims administrative contractors through a competitive process and to do so in accordance with Federal Acquisition Regulation (FAR). In FY 2014, Medicare Administrative Contractors (MACs) processed almost 1.2 billion claims totaling more than $363 in Medicare payments. This report evaluates (1) differences in responsibilities among MACs and the costs associated with these responsibilities, including any changes since the implementation of contracting reform; (2) lessons learned, if any, since CMS implemented contracting reform that could be used to increase MAC efficiency and effectiveness; and (3) alternative contracting approaches that CMS could use to enhance contractor performance. Tables. This is a print on demand report.
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