Beneficiaries (51 - 60 of 186 items)
Defense Health Care: DOD Lacks Assurance That Selected Reserve Members Are Informed about TRICARE Reserve Select
GAO-11-551: Published: Jun 3, 2011. Publicly Released: Jun 3, 2011.
TRICARE Reserve Select (TRS) provides certain members of the Selected Reserve--reservists considered essential to wartime missions--with the ability to purchase health care coverage under the Department of Defense's (DOD) TRICARE program after their active duty coverage expires. TRS is similar to TRICARE Standard, a fee-forservice option, and TRICARE Extra, a preferred provider option. The Nationa...
Defense Health Care: Access to Civilian Providers under TRICARE Standard and Extra
GAO-11-500: Published: Jun 2, 2011. Publicly Released: Jun 2, 2011.
The Department of Defense (DOD) provides health care through its TRICARE program, which is managed by the TRICARE Management Activity (TMA). TRICARE offers three basic options. Beneficiaries who choose TRICARE Prime, an option that uses civilian provider networks, must enroll. TRICARE beneficiaries who do not enroll in this option may obtain care from nonnetwork providers under TRICARE Standard or...
End-Stage Renal Disease: CMS Should Assess Adequacy of Payment When Certain Oral Drugs Are Included and Ensure Availability of Quality Monitoring Data
GAO-11-365: Published: Mar 23, 2011. Publicly Released: Mar 23, 2011.
For most individuals with end-stage renal disease (ESRD), Medicare purchases a bundle of dialysis-related services using a single payment. In 2014, the Centers for Medicare & Medicaid Services (CMS) plans to include in this bundled payment "oral-only" ESRD drugs used to treat mineral and bone disorder. Currently, Medicare generally pays for these drugs only if the beneficiary has Part D prescripti...
DOD Health Care: Prohibition on Financial Incentives That May Influence Health Insurance Choices for Retirees and Their Dependents under Age 65
GAO-11-160R: Published: Feb 16, 2011. Publicly Released: Mar 18, 2011.
From fiscal years 2001 through 2010, the Department of Defense's (DOD) spending for health care increased from about $19 billion to nearly $49 billion, representing approximately 6 percent of DOD's total spending in fiscal year 2001 and approximately 9 percent in fiscal year 2010. This health care spending primarily funds TRICARE--DOD's program that provides health care to active duty personnel an...
Medicare: CMS Has Addressed Some Implementation Problems from Round 1 of the Durable Medical Equipment Competitive Bidding Program for the Round 1 Rebid
GAO-10-1057T: Published: Sep 15, 2010. Publicly Released: Sep 15, 2010.
To reduce spending on durable medical equipment (DME) and related items, under federal law the Centers for Medicare & Medicaid Services (CMS) is phasing in, with several rounds of bidding, a competitive bidding program (CBP) for certain DME and other items. Because of numerous concerns, the Medicare Improvements for Patient and Providers Act of 2008 (MIPPA) terminated the CBP round 1 supplier cont...
Medicare Fraud, Waste, and Abuse: Challenges and Strategies for Preventing Improper Payments
GAO-10-844T: Published: Jun 15, 2010. Publicly Released: Jun 15, 2010.
GAO has designated Medicare as a high-risk program since 1990, in part because the program's size and complexity make it vulnerable to fraud, waste, and abuse. Fraud represents intentional acts of deception with knowledge that the action or representation could result in an inappropriate gain, while abuse represents actions inconsistent with acceptable business or medical practices. Waste, which i...
Home Infusion Therapy: Differences between Medicare and Private Insurers' Coverage
GAO-10-426: Published: Jun 7, 2010. Publicly Released: Jun 14, 2010.
Infusion therapy--drug treatment generally administered intravenously--was once provided strictly in hospitals. However, clinical developments and emphasis on cost containment have prompted a shift to other settings, including the home. Home infusion requires coordination among providers of drugs, equipment, and skilled nursing care, as needed. GAO was asked to review home infusion coverage polici...
End-Stage Renal Disease: CMS Should Monitor Access to and Quality of Dialysis Care Promptly after Implementation of New Bundled Payment System
GAO-10-295: Published: Mar 31, 2010. Publicly Released: Apr 30, 2010.
Medicare covers dialysis for most individuals with end-stage renal disease (ESRD). Beginning in January 2011, the Centers for Medicare & Medicaid Services (CMS) is required to use a single payment to pay for dialysis and related services, which include injectable ESRD drugs. Questions have been raised about this new payment system's effects on the access to and quality of dialysis care for certain...
Defense Health Care: 2008 Access to Care Surveys Indicate Some Problems, but Beneficiary Satisfaction Is Similar to Other Health Plans
GAO-10-402: Published: Mar 31, 2010. Publicly Released: Mar 31, 2010.
The Department of Defense (DOD) provides health care and mental health care through its TRICARE program. Under TRICARE, beneficiaries may obtain care through TRICARE Prime, an option that includes the use of civilian provider networks and requires enrollment. TRICARE beneficiaries who do not enroll in this option may obtain care from nonnetwork providers through TRICARE Standard, or from network p...
VA Health Care: VA Has Taken Steps to Make Services Available to Women Veterans, but Needs to Revise Key Policies and Improve Oversight Processes
GAO-10-287: Published: Mar 31, 2010. Publicly Released: Mar 31, 2010.
In 2008, VA provided health care to over 281,000 women veterans, a fast growing subgroup of veterans. Women veterans seeking VA health care need access to an array of services and Congress has raised concerns about how well VA is prepared to meet the physical and mental health care needs of women. GAO was asked to examine (1) the on-site availability of health care services at VA facilities for wo...