Medicare (81 - 90 of 534 items)
Medicare Managed Care: Observations about Medicare Cost Plans
GAO-10-185: Published: Dec 28, 2009. Publicly Released: Dec 28, 2009.
Medicare cost plans--managed care plans paid based on the reasonable costs of delivering Medicare-covered services--enroll a small number of beneficiaries compared to Medicare Advantage (MA), Medicare's managed care program in which the plans accept financial risk if their costs exceed fixed payments received for each enrolled beneficiary. Despite the small enrollment, industry representatives sta...
Indian Health Service: Updated Policies and Procedures and Increased Oversight Needed for Billings and Collections from Private Insurers
GAO-10-42R: Published: Oct 22, 2009. Publicly Released: Nov 23, 2009.
The Indian Health Service (IHS), an agency in the Department of Health and Human Services (HHS), provides health care services to American Indians and Alaskan Natives. For fiscal year 2009, Congress appropriated approximately $3.6 billion for health care services to be made available through IHS. The agency provides direct medical care, including primary care services, ancillary services, and some...
Medicare: Per Capita Method Can Be Used to Profile Physicians and Provide Feedback on Resource Use
GAO-09-802: Published: Sep 25, 2009. Publicly Released: Oct 26, 2009.
The Medicare Improvements for Patients and Providers Act of 2008 directed the Secretary of Health and Human Services to develop a program to give physicians confidential feedback on the Medicare resources used to provide care to Medicare beneficiaries. GAO was asked to evaluate the per capita methodology for profiling physicians--a method which measures a patient's resource use over a fixed period...
Improper Payments: Responses to Posthearing Questions Related to Eliminating Waste and Fraud in Medicare and Medicaid
GAO-09-838R: Published: Jul 20, 2009. Publicly Released: Jul 20, 2009.
On April 22, 2009, GAO testified before the subcommittee at a hearing entitled, "Eliminating Waste and Fraud in Medicare and Medicaid." This letter responds to a May 29, 2009, request for responses to questions for the record related to our April 22, 2009, testimony. The questions are as follows: (1) What do you see as the biggest challenge for CMS to provide an estimate for improper payments unde...
Prescription Drugs: Overview of Approaches to Control Prescription Drug Spending in Federal Programs
GAO-09-819T: Published: Jun 24, 2009. Publicly Released: Jun 24, 2009.
Millions of individuals receive prescription drugs through federal programs. The increasing cost of prescription drugs has put pressure to control drug spending on federal programs such as the Federal Employees Health Benefits Program (FEHBP), Medicare Part D, the Department of Veterans Affairs (VA), the Department of Defense (DOD), and Medicaid. Prescription drug spending within the FEHBP in part...
Hospital Emergency Departments: Bibliography (GAO-09-348SP, April 30, 2009), an E-supplement to GAO-09-347
GAO-09-348SP: Published: Apr 30, 2009. Publicly Released: Jun 1, 2009.
This is an e-supplement to GAO-09-347. This document presents a bibliography of a literature review conducted as part of our work on emergency department crowding (GAO-09-347). As part of our work to analyze and report on information made available since 2003 about (1) three indicators of emergency department crowding--ambulance diversion, wait times, and patient boarding, and (2) factors that con...
Hospital Emergency Departments: Crowding Continues to Occur, and Some Patients Wait Longer than Recommended Time Frames
GAO-09-347: Published: Apr 30, 2009. Publicly Released: Jun 1, 2009.
Hospital emergency departments are a major part of the nation's health care safety net. Of the estimated 119 million visits to U.S. emergency departments in 2006, over 40 percent were paid for by federally-supported programs. These programs--Medicare, Medicaid, and the State Children's Health Insurance Program--are administered by the Department of Health and Human Services (HHS). There have been...
Nonprescription Drugs: Considerations Regarding a Behind-the-Counter Drug Class
GAO-09-245: Published: Feb 20, 2009. Publicly Released: Mar 23, 2009.
In the United States, most nonprescription drugs are available over-the-counter (OTC) in pharmacies and other stores. Experts have suggested that drug availability could be increased by establishing an additional class of nonprescription drugs that would be held behind the counter (BTC) but would require the intervention of a pharmacist before being dispensed; a similar class of drugs exists in ma...
Medicare: Improvements Needed to Address Improper Payments in Home Health
GAO-09-185: Published: Feb 27, 2009. Publicly Released: Mar 13, 2009.
Medicare spending on home health totaled $12.9 billion in 2006, up 44 percent from 2002. Concerns have been raised that improper payments from practices indicating fraud and abuse may have contributed to Medicare home health spending and utilization. The Centers for Medicare & Medicaid Services (CMS), the agency that administers Medicare, is responsible for minimizing improper payments made on beh...
Debt Management: Treasury's Cash Management Challenges and Timing of Payments to Medicare Private Plans
GAO-09-118: Published: Jan 30, 2009. Publicly Released: Mar 2, 2009.
A timing difference between cash in- and outflows poses challenges for the Department of the Treasury. Increased volatility of monthly cash flows may lead to unexpected short-term debt issuance and hence increased borrowing. While Social Security payments made at the start of the month will diminish gradually in coming years, start-of month payments to Medicare plan sponsors for Medicare Advantage...