HCFA's Approach to Evaluating Medicare Technology

AIMD-95-234R: Published: Sep 29, 1995. Publicly Released: Sep 29, 1995.

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Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) approach to analyzing the benefits of commercial technology in the Medicare program. GAO noted that HCFA: (1) is limiting its analysis of the benefits of commercial technology to determining whether Medicare contractors complied with existing payment controls and is using a flawed sampling methodology to select claims for review; (2) is attempting to verify the savings achievable through commercial systems without understanding how the systems operate; (3) believes that it cannot examine commercial systems without actually procuring a system; and (4) is failing to identify real monetary benefits of commercial detection systems in its analysis.

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