GAO report: CMS financial records don't line up

The Centers for Medicare & Medicaid Services lacks a sound financial management system, according to a new report issued by the Government Accountability Office.

GAO looked into CMS records, dating back from implementation of the Affordable Care Act in March 2010 through fiscal year 2014. GAO intended to examine the resources received and used, sources of funding and total number of staff used to carry out the healthcare reform law.

So to conduct the investigation, GAO contacted officials at CMS to request data relating to expenditures, including individuals' salaries and travel activities, notes the report. Then, GAO compared the information provided by CMS with official numbers from the Healthcare Integrated General Ledger Accounting System. 

The report found:

  • CMS funding of $3.7 billion for fiscal year 2014 was accurate
  • When comparing data, the number of staff--347--lined up
  • Total salary expenditures were correct, at $79.8 million

While the above did pan out well for CMS, GAO discovered some discrepancies.

First, it could not determine the accuracy of any other financial services, namely, expenditures relating to polling, focus groups or advertising. This is due to the fact that CMS's system does not captures these activities' expenditures in a reliable fashion.

GAO also found incomplete data regarding CMS staff reassignments, which in turn, could not be verified by the information provided.

This is not the first time CMS faces scrutiny for information not lining up. Last spring, the GAO discovered that insurers selling Medicare Advantage plans received as much as $5.1 billion in overpayments between 2010 and 2012. Apparently, CMS did not appropriately adjust the members' risk scores to account for the insurers' differences in treatment.

Then back in July, the GAO discovered that was developed without effective planning or oversight, FierceHealthPayer previously reported.

For more:
- here's the full report (.pdf)