TOPICS
TOPICS
Watchdog finds 'pervasive deficiencies' in Medicare contract management
The Government Accountability Office has again found widespread flaws in how the office administering Medicare and Medicaid manages contracts.
The watchdog agency studied a random sample of contract actions at the Centers for Medicare and Medicaid Services and estimated that more than 84 percent of fiscal 2008 contract actions had at least one instance where officials failed to implement a key internal control. GAO also determined that at least 37 percent of fiscal 2008 contract actions had three or more deficiencies.
"Internal control -- the plans, methods and procedures used to meet missions, goals and objectives -- is the first line of defense in safeguarding assets and preventing and detecting fraud and errors, and helps government program managers achieve desired results through effective stewardship of public resources," GAO stated in its report.
CMS, which administers other programs such as the State Children's Health Insurance Program, in addition to the high-risk Medicare and Medicaid programs, relies "extensively" on contractors, according to GAO. Contractors perform basic mission functions such as program administration, management and oversight of the health programs. They administer, oversee and audit Medicare claims; provide information technology systems and consulting services; and operate the toll-free Medicare help line. In fiscal 2008, CMS obligated $3.6 billion in contracts.
GAO gave a number of examples of deficiencies, including the use of cost reimbursement contracts without first ensuring the contractor had an adequate accounting system and failure on the part of project officers to certify invoices for payment.
The watchdog agency said the problems stemmed from "a weak overall control environment," characterized by inadequate strategic planning for funding and personnel. The office also failed to fully collect data on its acquisitions, hindering its ability to identify areas of risk, according to GAO.
This is not the first time GAO has looked into contract management at CMS. The watchdog issued a report in 2007 recommending internal control improvements. CMS has failed to address most of those recommendations, GAO said in the new report. For example, CMS has not made progress clarifying the roles and responsibilities for certain contract oversight functions and, as of July, it had a backlog of contracts overdue for closeout. This backlog put the office at risk of not identifying and recovering improper payments or waste, GAO noted.
GAO made 10 recommendations for developing policies to improve oversight and strengthen the CMS control environment. The watchdog also reaffirmed seven prior recommendations that have not been fully implemented. CMS concurred with the new advice, but challenged GAO's assessment of its progress on the prior suggestions.
COMMENTS
- above "comments" appear to sadly include fluff and hyperbole, and others appear to be riding on a wave of partisan-type hype. For those seeking as accurate picture as possible, I would encourage them to stick to a wide array of formal reports, congressional transcripts, and customer survey results. Anom Posted December 2, 2009 8:12 AM
- Used to work there - couldn't take all the "fraud, waste and abuse"! We were told to "enter anything into DCIS (which feeds into FPDS) - it really doesn't matter. This provided false data to the government and public, including percentage of small business awards. We were told to "pay all invoices - don't even review them - we'll check them later" so they could avoid the prompt payment act penalties and because no one even paid attention to what a realistic invoice from a contractor would be. When we received calls from the public about Medicare or Medicaid fraud they had witnessed - we were to transfer the call to the voicemail of an empty desk so no one would have to deal with the issue. Emails about fraud were shredded. The reason contract closeout cannot occur: 1. They can't find the files - never kept files, etc. They actually ask the contractors to send them the award documents. Headquarters in DC actually forbid the extended use of certain IDIQ contracts because of the "irregularities". 2. The agency is full of very lazy GS employees who don't even do one day's work per month. 3. If sommeone were to ask an employee to actually work - the employee would head right down to the union office and complain. This agency MUST be disbanded immediately! Another Former CMS Employee Posted December 1, 2009 12:28 PM
- As is the case with most federal agencies that GAO identifies as having contract management issues- this is no surprise since CMS, along with many other agencies, fail to provide proper contract and ethics training, funding for training, and fail to put in place a strong accountability system to hold everyone from the top down accountable. An agency, and its personnel cannot be professional and demonstrate competence if they don't have a plan, enforce the plan and manage to the plan. In most cases in the federal government where I have seen poor contract management it has almost always been at the top, by career bureaucrats who exhibited the "Peter Principle" or by political appointees whose only interest was their own. In such cases, agencies are ripe for scandals, and criminal actions because they do not instil a true sense of personal integrity in its members, to achieve the high ethical standards that taxpayers do expect of those spending their money. Robert Knauer CPCM CPPO Posted December 1, 2009 12:09 PM
