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Following years of provider disputes, the Government Accountability Office released a reportMonday encouraging the Centers for Medicare & Medicaid Services to look at ways to improve the Medicare Administrative Contractor program.
The GAO report examined differences in responsibilities among MACs and the costs associated with those differences. It says reforms could increase efficiency and effectiveness through alternative contracting approaches.
MAC responsibilities include claims processing and customer service, which account for most of their reported costs. As of February 2015, 16 MACs — chosen by the CMS through a competitive process in accordance with the Federal Acquisition Regulation — administered claims submitted by Medicare providers and suppliers. Twelve MACs administered claims for inpatient hospital care, outpatient physician and hospital services, and home health and hospice care, among other services, while the remaining four MACs administered claims for durable medical equipment.
Read more: CMS should look at contractor performance, government agency says
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