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Capitol Health Call
January 13, 2010

Pervasive Deficiencies

JAMA. 2010;303(2):125. doi:10.1001/jama.2009.1944

The Centers for Medicare & Medicaid Services (CMS) relies extensively on contractors to assist in the administration, management, and oversight of its health programs. But the agency's internal controls over these service providers continue to have pervasive deficiencies that increase the risk of improper payments and waste, according to a report released November 24 by the Government Accountability Office (GAO).

In the report (, the GAO estimated that at least 84% of contract actions involving $3.6 billion in fiscal year 2008 contained at least 1 instance in which a key control was not adequately implemented; at least 37% of contract actions had 3 or more such problems. The GAO also noted that of the 9 recommendations it made in 2007 to the CMS to improve internal controls, 7 had not been substantially addressed.

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