Experiments Have Not Demonstrated Success of Competitive Fixed-Price Contracting in Medicare
HRD-82-17
Published: Dec 01, 1981. Publicly Released: Dec 01, 1981.
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Highlights
GAO reviewed three experimental fixed-price contracts in Medicare part B. The review focused principally on the experimental contract in Illinois and addressed the Health Care Financing Administration's (HCFA) progress in implementing contractor performance standards and carrying out previous GAO recommendations.
Recommendations
Recommendations for Executive Action
Agency Affected | Recommendation | Status |
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Department of Health and Human Services | The Secretary of the Department of Health and Human Services should direct the Health Care Financing Administration to analyze the large amounts of unrecovered overpayments in Illinois, now estimated to be about $27.7 million. Such an analysis might identify patterns to these overpayments and result in the recovery of some of this money. |
Closed – Not Implemented
Followup on this report should be terminated because GAO will follow up on the action taken in connection with a separate, but related subsequent report entitled "Need to Recover Medicare Part B Duplicate Payments in Illinois" (GAO/HRD-82-67, dated April 30, 1982).
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Topics
Claims settlementContract costsContract performanceFixed price contractsMedicareOverpaymentsPerformance measuresQuestionable procurement chargesSource selectionUnderpayments