Senate to Look into Potential Medicare Contractor Conflicts

March 2, 2011 · Posted in Industry News, RAC 

Three Senate committee chairmen asked the Department of Health and Human Services Inspector General to look into potential conflicts of interest among private sector contractors that perform many of the payment, administration and oversight functions of Medicare.

The chairmen say that a recent survey of contractors conducted by their staffs to examine problems within the Medicare program identified several relationships between key Medicare contractors “that raise questions about possible conflicts of interest, or at the very least, might present the appearance of a conflict of interest.”

In some instances, the oversight contractor is a subsidiary of a company with a Medicare claims processing contract; in other instances, the claims contractor is a subsidiary of a parent company that also has a subsidiary with an oversight contract.

Congressional staffers said they have been reviewing the relationship of subsidiaries of WellPoint Inc., Hewlett Packard Co’s EDS Corp., and several other Medicare contractors hired by the government to monitor the bills healthcare providers send to Medicare, according to media reports.

[Extracted from: Fierce Healthcare]

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