Medical services rates (71 - 80 of 84 items)
Simulations of a Medicare Prospective Payment System for Home Health Care
HRD-85-110: Published: Sep 30, 1985. Publicly Released: Sep 30, 1985.
Pursuant to a congressional request, GAO simulated the probable prospective payment rates for home health care under the Medicaid program.The system GAO modeled specified that: (1) rates should be nationwide, and no distinction should be made between the rates for freestanding and facility-based providers; (2) rates should be set at the 75th percentile instead of the 60th percentile; (3) costs sho...
Additional Changes to the Medicare Reimbursement Rates for Major Joint Procedures Are Needed
HRD-85-109: Published: Sep 12, 1985. Publicly Released: Sep 12, 1985.
GAO reviewed the increase in the Medicare payment rate for bilateral or multiple joint replacement procedures in light of the resources used by the providers program costs.GAO found that: (1) the payment rate for bilateral or multiple joint replacements was inadequate; (2) multiple replacements required more hospital resources than single replacements; (3) charges for these procedures exceeded pay...
Use of Unaudited Hospital Cost Data Resulted in Overstatement of Medicare's Prospective Payment System Rates
HRD-85-74: Published: Jul 18, 1985. Publicly Released: Jul 18, 1985.
GAO reviewed: (1) the effect of the Health Care Financing Administration's (HCFA) use of unaudited cost reports to determine the standardized amount used in computing prospective payment system (PPS) rates; and (2) the effect of not removing all capital costs from the cost data even though these costs are paid separately from PPS rates.GAO noted that HCFA used unaudited data and some capital costs...
Medicare Payments to Hospitals
126949: May 14, 1985
GAO discussed two issues related to Medicare reimbursement to hospitals, including: (1) the impact of the Health Care Financing Administration's (HCFA) use of unaudited hospital cost reports in establishing the Prospective Payment System (PPS) payment rates; and (2) the return on equity payments to proprietary hospitals. GAO found that in calculating the national PPS payment rates, HCFA: (1) made...
Excessive Respiratory Therapy Cost and Utilization Data Used in Setting Medicare's Prospective Payment Rates
HRD-84-90: Published: Sep 28, 1984. Publicly Released: Sep 28, 1984.
GAO examined the accuracy of the data used by the Department of Health and Human Services (HHS) to compute Medicare rates payed to hospitals.Because of concern that the Medicare cost reimbursement system did not provide hospitals with incentives to hold down their cost increases, Congress enacted a payment system under which hospitals are paid a predetermined amount for each Medicare discharge bas...
Payment Rates for Ambulatory Surgery Centers Are Higher Than Intended by HCFA
HRD-84-67: Published: Jul 12, 1984. Publicly Released: Jul 12, 1984.
GAO examined the methodology used by the Health Care Financing Administration (HCFA) for establishing the standard overhead amounts to be paid to ambulatory surgery centers (ASC) and compared the cost to Medicare for surgery performed in ambulatory versus inpatient settings.The Omnibus Reconciliation Act of 1980 authorized payments under Medicare to ASC to cover their operating costs. The payment...
Costs Related Medicaid Reimbursements to Nursing Homes in the State of Kansas
103500: Sep 8, 1977
Controls and procedures used to reimburse nursing homes in Kansas for services provided patients under the Medicaid program were surveyed. The analysis focused on the State's method of establishing reimbursement rates, selected program providers' cost reports which the State used to establish these rates, and four providers' records in order to verify the propriety of selected costs included in th...
Treatment of Ineligible Veterans in Veterans Administration Hospitals
102225: May 10, 1977
Numerous indebtedness claim referrals have been received from the Hines, Illinois, Veterans Administration (VA) hospital for medical treatment to persons who were subsequently found not eligible for VA medical benefits.Thirty cases were referred to GAO for collection from the Hines VA Hospital for hospital stays from November 1972 to June 1976. The amount of the claims totaled about $89,000. In 14...
Audit of Medicaid Costs Reported by Autumn Hills Convalescent Centers, Inc., Houston, TX
HRD-83-9: Published: Oct 14, 1982. Publicly Released: Nov 9, 1982.
Pursuant to a congressional request, GAO examined unallowable and questionable central office costs of a chain of nursing homes participating in the Medicaid program in Texas and focused on the costs reported by one home about which there have been allegations of poor patient care.Although GAO questioned about 18 percent of the central office costs for 1980 and a Texas Department of Human Resource...
Information on Medicare's Hospital Inpatient Routine Operating Cost Reimbursement Limits for Duluth-Superior
HRD-82-24: Published: Dec 22, 1981. Publicly Released: Dec 22, 1981.
The methodology which the Health Care Financing Administration (HCFA) uses in establishing Medicare's reimbursement limits for hospital inpatient routine operating costs was questioned. GAO was asked to investigate the HCFA methods in establishing the wage index used in the July 1, 1979 and 1980, reimbursement limits.The hospital inpatient routine operating cost reimbursement limit is the ceiling...