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GAO-17-735SP 1 (2017-09-12)

handle is hein.gao/gaobaaldf0001 and id is 1 raw text is: G A O U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 September 12, 2017 The Honorable Orrin G. Hatch Chairman Committee on Finance United States Senate CENTERS FOR MEDICARE AND MEDICAID SERVICES: Analysis of Contracting Data Dear Mr. Chairman: The Centers for Medicare and Medicaid Services (CMS) within the Department of Health and Human Services (HHS) is responsible for administering the Medicare program and, in conjunction with the states, the Medicaid program. CMS uses an extensive network of private contractors to carry out its responsibilities, including benefit delivery, program administration, management, and oversight. These contractors perform a variety of functions such as handling claims under the Medicare program and maintaining information technology (IT) systems. In prior work, we have found that CMS could strengthen its processes for selecting and overseeing contractors under the Medicare program.1 HHS has concurred with our findings, but has not implemented some of our most recent recommendations. Enclosure 1 summarizes our key outstanding recommendations to CMS. You requested that we review contracting trends at CMS. This report identifies what federal procurement data show regarding recent CMS contracting in areas such as total spending, competition rates, and contract types. We used data from the Federal Procurement Data System-Next Generation (FPDS-NG) over the 5-year period from fiscal years 2012 through 2016, the most recent and complete data available at the time of our review, to determine the range of products and services CMS procured, including items procured using commercial item procedures under Part 12 of the Federal Acquisition Regulation.2 We also used the FPDS-NG data to determine how CMS procures its products and services-including competition rates and contract types-and to identify what types of contractors received contracts, including small business contractors. 1GAO, Medicare Advantage: CMS Should Use Data on Disenrollment and Beneficiary Health Status to Strengthen Oversight, GAO-i 7-393 (Washington, D.C.: Apr. 28, 2017); Medicare Advantage: Fundamental Improvements Needed in CMS's Effort to Recover Substantial Amounts of Improper Payments, GAO-1 6-76 (Washington, D.C.: Apr. 8, 2016); Medicare Part D: Changes Needed to Improve CMS's Recovery Audit Program Operations and Contractor Oversight, GAO-1 5-633 (Washington, D.C.: Aug. 14, 2015); Medicare Administrative Contractors: CMS Should Consider Whether Alternative Approaches could Enhance Contractor Performance, GAO-1 5-372 (Washington, D.C: Apr. 30, 2015). 2In addition to contracting with contractors to fulfill unique government requirements, agencies can procure commercial items, such as products and services from the commercial marketplace, using streamlined solicitation and evaluation procedures. GAO-1 7-735SP CMS Contracting Page 1

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