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HEHS-94-143R 1 (1994-04-20)

handle is hein.gao/gaobacknn0001 and id is 1 raw text is: !s13W? GAO United States General Accounting Office Washington, D.C. 20548 Human Resources Division B-256778 April 20, 1994 The Honorable John D. Rockefeller IV Chairman, Subcommittee on Medicare and Long-Term Care Committee on Finance United States Senate Dear Mr. Chairman: As part of an overall strategy to improve the efficiency and effectiveness of Medicare operations, the Health Care Financing Administration (HCFA)--the agency within the Department of Health and Human Services that administers Medicare--has contracted for the design and development of a new automated claims processing system called the Medicare Transaction System (MTS). MTS is intended to replace the multiple claims processing systems currently used by Medicare contractors with a single government-owned system. In January 1994, we issued a report at your request that described the benefits HCFA expects from deploying MTS and the procurement safeguards needed to assure that MTS is designed and implemented as planned.' The report noted that inherent risks are associated with implementing a system the size and complexity of MTS, including cost overruns, schedule delays, and system deficiencies. To help address these concerns, we recommended continuous top management involvement and annual progress reports to congressional committees. Because the Congress is considering legislation to reform our nation's health care system at the same time that HCFA is developing a new claims processing system, concerns exist about whether MTS will be able to accommodate potential health care reform changes. As discussed with your staff, this letter provides additional information 'Medicare: New Claims Processing System Benefits and Acquisition Risks (GAO/HEHS/AIMD-94-79, Jan. 25, 1994). GAO/HEHS-94-143R Medicare Transaction System

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