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Other, Department of Health and Human Services, Executive (21 - 30 of 835 items)
Tiered Evidence Grants: Opportunities Exist to Share Lessons from Early Implementation and Inform Future Federal Efforts
GAO-16-818: Published: Sep 21, 2016. Publicly Released: Sep 21, 2016.
Tiered evidence grants are a new policy tool federal agencies are using to incorporate evidence of effectiveness into grantmaking. Under this approach, agencies establish tiers of grant funding based on the level of evidence grantees provide on their models for providing social, educational, health, or other services. Smaller awards are used to test new and innovative service models; larger awards...
Long-Term Care Workforce: Better Information Needed on Nursing Assistants, Home Health Aides, and Other Direct Care Workers
GAO-16-718: Published: Aug 16, 2016. Publicly Released: Sep 15, 2016.
Federal data sources provide a broad picture of direct care workers—nursing assistants and home health, psychiatric, and personal care aides—who provide long-term services and supports (LTSS), but limitations and gaps affect the data's usefulness for workforce planning. Some states have collected data in areas where federal data are limited, but these have been one-time studies. Federal data s...
Generic Drugs Under Medicare: Part D Generic Drug Prices Declined Overall, but Some Had Extraordinary Price Increases
GAO-16-706: Published: Aug 12, 2016. Publicly Released: Sep 12, 2016.
Generic drug prices declined overall under Medicare Part D—the voluntary outpatient prescription drug program administered by the Centers for Medicare & Medicaid Services within the Department of Health and Human Services (HHS)—since 2010. Specifically, generic drug prices fell 59 percent from the first quarter of 2010 through the second quarter of 2015. This decline reflects a changing basket...
Patient Protection and Affordable Care Act: Final Results of Undercover Testing of the Federal Marketplace and Selected State Marketplaces for Coverage Year 2015
GAO-16-792: Published: Sep 9, 2016. Publicly Released: Sep 12, 2016.
Under the Patient Protection and Affordable Care Act (PPACA), health-insurance marketplaces are required to verify application information to determine eligibility for enrollment and, if applicable, determine eligibility for income-based subsidies or Medicaid. Verification steps include reviewing and validating an applicant's Social Security number, if one is provided; citizenship, status as a U.S...
Patient Protection and Affordable Care Act: Results of Undercover Enrollment Testing for the Federal Marketplace and a Selected State Marketplace for the 2016 Coverage Year
GAO-16-784: Published: Sep 12, 2016. Publicly Released: Sep 12, 2016.
The Patient Protection and Affordable Care Act (PPACA) requires health-insurance marketplaces to verify application information to determine eligibility for enrollment and, if applicable, determine eligibility for income-based subsidies. Verification steps include validating the applicant's Social Security number, if one is provided; citizenship or immigration status; and household income. PPACA r...
Medicaid: Key Policy and Data Considerations for Designing a Per Capita Cap on Federal Funding
GAO-16-726: Published: Aug 10, 2016. Publicly Released: Sep 9, 2016.
Through review of its prior reports, the literature and interviews with state Medicaid officials and subject matter experts, GAO identified several key interrelated policy considerations that could be useful should policymakers elect to pursue a per capita cap—a per-enrollee limit on federal Medicaid funding for states.Coverage and flexibility. Coverage entails decisions about whether all or a s...
Foster Care: Most Tribes Do Not Anticipate Challenges with Case Goal Changes, but HHS Could Further Promote Guardianship Assistance
GAO-16-625: Published: Aug 8, 2016. Publicly Released: Sep 7, 2016.
To receive federal child welfare funding, state and tribal child welfare agencies must comply with certain requirements, including developing a permanency plan for the child that identifies how the child will exit the foster care system to a permanent home (“case goal”). If other case goals, such as reunifying with parents, adoption, or guardianship are not possible or appropriate, a child may...
Federal Workforce: Opportunities Exist to Improve Data on Selected Groups of Special Government Employees
GAO-16-548: Published: Jul 15, 2016. Publicly Released: Aug 15, 2016.
Federal agencies made limited use of special government employees (SGE) not serving on federal boards. As of December 2014, approximately 3 percent of SGEs (1,138 of 40,424) were working as experts or consultants and not serving on federal boards, according to the Office of Government Ethics (OGE). Over a 10-year period (2005 to 2014), GAO found that agencies used an annual average of approximatel...
Patient Protection and Affordable Care Act: Information on Approval Process for State Innovation Waivers
GAO-16-637R: Published: Jul 6, 2016. Publicly Released: Aug 5, 2016.
The Departments of Health and Human Services (HHS) and Treasury (Treasury; referred to together as the Departments) have established a number of controls in their process for approving state proposals to waive certain provisions of the Patient Protection and Affordable Care Act (PPACA), referred to as 1332 waivers. These controls seek to ensure that approved waivers meet the statutory criteria of...
Medicare Fee-For-Service: Opportunities Remain to Improve Appeals Process
GAO-16-366: Published: May 10, 2016. Publicly Released: Jun 9, 2016.
The appeals process for Medicare fee-for-service (FFS) claims consists of four administrative levels of review within the Department of Health and Human Services (HHS), and a fifth level in which appeals are reviewed by federal courts. Appeals are generally reviewed by each level sequentially, as appellants may appeal a decision to the next level depending on the prior outcome. Under the administr...