Health insurance (81 - 90 of 231 items)
Medicare: Financial Challenges and Considerations for Reform
GAO-03-577T: Published: Apr 10, 2003. Publicly Released: Apr 10, 2003.
We are pleased to be here today as Congress examines Medicare's financial health and consider the budgetary and economic challenges presented by an aging society. The Comptroller General has been particularly attentive to the sustainability challenges faced by the nation's two largest entitlement programs--Medicare and Social Security--for more than a decade since he served as a public trustee for...
Medicare: Observations on Program Sustainability and Strategies to Control Spending on Any Proposed Drug Benefit
GAO-03-650T: Published: Apr 9, 2003. Publicly Released: Apr 9, 2003.
The House Committee on Ways and Means is holding a hearing on modernizing Medicare and integrating prescription drugs into the program. There are growing concerns about gaps in the Medicare program, most notably the lack of outpatient prescription drug coverage, which may leave Medicare's most vulnerable beneficiaries with high out-of-pocket costs. At the same time, Medicare already faces a huge p...
Health Insurance: States' Protections and Programs Benefit Some Unemployed Individuals
GAO-03-191: Published: Oct 25, 2002. Publicly Released: Nov 27, 2002.
The six states reviewed had in place a variety of protections, established prior to the economic downturn, to assist unemployed individuals in maintaining health insurance coverage: State-mandated continuation coverage, which required small businesses to extend their group health coverage to former employees and their families who choose to pay for it. Guaranteed conversion, which required insurer...
Medicare: Recent CMS Reforms Address Carrier Scrutiny of Physicians' Claims for Payment
GAO-02-693: Published: May 28, 2002. Publicly Released: May 28, 2002.
In 1990, GAO designated the Medicare program to be at high-risk for waste, fraud, and abuse. More than a decade later, Medicare remains on GAO's high-risk list. This report examines Medicare's claims review process, which is designed to detect improper billing or payments. GAO found that most physicians who bill Medicare are largely unaffected by carriers' medical reviews, with 90 percent of physi...
Medicare: Beneficiary Use of Clinical Preventive Services
GAO-02-422: Published: Apr 10, 2002. Publicly Released: May 23, 2002.
Preventive medicine, including immunizations for many diseases and screening for some types of cancer, holds the promise to extend and improve the quality of life for millions of Americans. Medicare now covers three preventive services for immunizations and three for screenings, and the Centers for Medicare and Medicaid Services (CMS) sponsors "interventions" to increase the use of preventive serv...
Children's Health Insurance: Inspector General Reviews Should Be Expanded to Further Inform the Congress
GAO-02-512: Published: Mar 29, 2002. Publicly Released: Mar 29, 2002.
Congress created the State Children's Health Insurance Program (SCHIP) in 1997 to reduce the number of uninsured children in families with incomes that are too high to qualify for Medicaid. Financed jointly by the states and the federal government, SCHIP encourages state participation by offering a higher federal matching rate than the Medicaid program. Concerns have been raised that states might...
Medicaid and SCHIP: States' Enrollment and Payment Policies Can Affect Children's Access to Care
GAO-01-883: Published: Sep 10, 2001. Publicly Released: Oct 10, 2001.
States provide health care coverage to low-income uninsured children largely through two federal-state programs--Medicaid and the State Children's Health Insurance Program (SCHIP). Medicaid was established in 1965 to provide health care coverage to low-income adults and children. Medicaid expenditures for health services to 22.3 million children totaled $32.4 billion in 1998. Congress established...
Medicare: Comments on HHS' Claims Administration Contracting Reform Proposal
GAO-01-1046R: Published: Aug 17, 2001. Publicly Released: Sep 10, 2001.
The Department of Health and Human Services (HHS) submitted a legislative proposal that would modify Medicare's contracting authority. This report examines (1) the current law and practice in Medicare claims administration contracting, (2) provisions in the proposal that would increase HHS Centers for Medicare and Medicaid Services' (CMS) contracting flexibility, and (3) the provisions that deviat...
Medicare: Successful Reform Requires Meeting Key Management Challenges
GAO-01-1006T: Published: Jul 25, 2001. Publicly Released: Jul 25, 2001.
Management of Medicare has come under increasing scrutiny. The Health Care Financing Administration (HCFA) has had mixed success running the program. The agency has developed payment methods that have contained cost growth, and HCFA has paid fee-for-service claims quickly and at low administrative cost. However, HCFA has had difficulty ensuring that it paid claims appropriately. In addition, Medic...
Regulatory Issues for Medicare Providers
GAO-01-802R: Published: Jun 11, 2001. Publicly Released: Jul 11, 2001.
Medicare is highly vulnerable to fraud, waste, and abuse. The enforcement of program payment rules, however, has raised concerns that these safeguards may have imposed too great a burden on health care providers. The proposed Medicare Education and Regulatory Fairness Act would seek to address some of these concerns by providing expedited procedures for provider appeals, new options for providers...