Senator questions Medicare agency’s use of Defense audit unit

A key Senate Republican wants the Centers for Medicare and Medicaid Services to justify its continued use of the Defense Contract Audit Agency to conduct financial audits.

In a draft letter Government Executive obtained, Iowa Sen. Charles Grassley raised concerns that CMS could be risking the reliability of its audits by contracting with DCAA, which has undergone nearly two years of turmoil since a federal watchdog questioned the agency's management and auditor independence. Grassley, the ranking member of the Senate Finance Committee, is expected to send the letter in the coming days.

The senator told CMS acting Administrator Charlene Frizzera in the letter that he has "deep concern that CMS is staking the integrity of its [Quality Improvement Organizations] audits and potentially other audits on the DCAA."

Quality Improvement Organizations are private groups of medical professionals CMS hires to work with health care providers in each state to review medical care and to help Medicare beneficiaries with complaints about the quality of services.

Under a 2008 agreement with CMS and the Health and Human Services Department's inspector general, DCAA performs financial-related audits of the various quality organizations. But Grassley -- a frequent critic of the organizations -- questioned why CMS would continue working with DCAA in light of recent issues the Government Accountability Office raised.

The letter cited a September 2009 GAO report that found widespread deficiencies with 69 audits and cost-related reviews at field offices in DCAA's five regions from 2004 through 2006. The watchdog agency identified similar problems in a 2008 report that examined auditing concerns at a pair of California DCAA field offices.

The senator also reiterated concerns, initially raised by the Project on Government Oversight, a federal watchdog group, that DCAA remains resistant to cultural changes, including how it awards promotions to staff.

Grassley first questioned CMS' relationship with DCAA, which he called a "substandard auditor," in June 2009. CMS leaders responded the following month that they were "satisfied with the quality and accuracy" of DCAA's audits.

"CMS makes every effort to work with DCAA to ensure that we obtain quality and accurate work products," Frizzera wrote at the time. "We also assume that in performing audits for CMS, DCAA is abiding by all applicable statutes, rules and regulations."

But, Grassley does not share CMS' confidence in DCAA's audit ability. He wants CMS to provide a written justification to his office for its continued contracting with DCAA and details of any independent verification of the agency's work. Grassley also wants to know if CMS contracts with DCAA for any other audits.

Between fiscal 2005 and 2008, CMS paid DCAA more than $2.8 million for its work with the quality improvement organizations, Frizzera said.

Stay up-to-date with federal news alerts and analysis — Sign up for GovExec's email newsletters.
Close [ x ] More from GovExec

Thank you for subscribing to newsletters from
We think these reports might interest you:

  • Sponsored by G Suite

    Cross-Agency Teamwork, Anytime and Anywhere

    Dan McCrae, director of IT service delivery division, National Oceanic and Atmospheric Administration (NOAA)

  • Data-Centric Security vs. Database-Level Security

    Database-level encryption had its origins in the 1990s and early 2000s in response to very basic risks which largely revolved around the theft of servers, backup tapes and other physical-layer assets. As noted in Verizon’s 2014, Data Breach Investigations Report (DBIR)1, threats today are far more advanced and dangerous.

  • Federal IT Applications: Assessing Government's Core Drivers

    In order to better understand the current state of external and internal-facing agency workplace applications, Government Business Council (GBC) and Riverbed undertook an in-depth research study of federal employees. Overall, survey findings indicate that federal IT applications still face a gamut of challenges with regard to quality, reliability, and performance management.

  • PIV- I And Multifactor Authentication: The Best Defense for Federal Government Contractors

    This white paper explores NIST SP 800-171 and why compliance is critical to federal government contractors, especially those that work with the Department of Defense, as well as how leveraging PIV-I credentialing with multifactor authentication can be used as a defense against cyberattacks

  • Toward A More Innovative Government

    This research study aims to understand how state and local leaders regard their agency’s innovation efforts and what they are doing to overcome the challenges they face in successfully implementing these efforts.

  • From Volume to Value: UK’s NHS Digital Provides U.S. Healthcare Agencies A Roadmap For Value-Based Payment Models

    The U.S. healthcare industry is rapidly moving away from traditional fee-for-service models and towards value-based purchasing that reimburses physicians for quality of care in place of frequency of care.

  • GBC Flash Poll: Is Your Agency Safe?

    Federal leaders weigh in on the state of information security


When you download a report, your information may be shared with the underwriters of that document.