Health care reform (1 - 10 of 89 items) in Custom Date Range
Military Health System: Sustained Senior Leadership Needed to Fully Develop Plans for Achieving Cost Savings
GAO-14-396T: Published: Feb 26, 2014. Publicly Released: Feb 26, 2014.
Department of Defense (DOD) senior leadership has demonstrated a commitment to oversee implementation of its military health system’s (MHS) reform and has taken a number of actions to enhance the reform efforts. For example, in March 2013, DOD chartered the MHS Governance Transition Organization to provide oversight, management, and support for the implementation. This entity is chartered to exi...
Defense Health Care Reform: Additional Implementation Details Would Increase Transparency of DOD's Plans and Enhance Accountability
GAO-14-49: Published: Nov 6, 2013. Publicly Released: Nov 6, 2013.
GAO determined that the Department of Defenses (DOD) March and June 2013 submissions on establishing a Defense Health Agency (DHA) to reform the governance of the Military Health System (MHS) met three statutory requirements to include information on goals, performance measures, and staffing; partially met one requirement to include information on timelines; and was not required to include i...
Health Insurance: Seven States' Actions to Establish Exchanges under the Patient Protection and Affordable Care Act
GAO-13-486: Published: Apr 30, 2013. Publicly Released: May 30, 2013.
The Patient Protection and Affordable Care Act (PPACA) and the Department of Health and Human Services (HHS) regulations, supplemented by HHS guidance, require states and American Health Benefit Exchanges (exchanges) to carry out a number of key functions, for which state responsibilities vary by exchange type. A state that chooses to operate its exchange is responsible for: (1) establishing an op...
Private Health Insurance: Expiration of the Health Coverage Tax Credit Will Affect Participants' Costs and Coverage Choices as Health Reform Provisions Are Implemented
GAO-13-147: Published: Dec 28, 2012. Publicly Released: Jan 28, 2013.
Expiration of the Health Coverage Tax Credit (HCTC) and implementation of Patient Protection and Affordable Care Act (PPACA) premium tax credits, cost-sharing subsidies, and Medicaid expansion will affect HCTC participants' costs for health plans in multiple ways. Projections from GAO's analysis of 2010 Internal Revenue Service (IRS) data show that most HCTC participants in 2014 will likely be eli...
Medicare: Implementation of Financial Incentive Programs under Federal Fraud and Abuse Laws
GAO-12-355: Published: Mar 30, 2012. Publicly Released: Apr 30, 2012.
Certain financial incentive programs are permitted within the framework of federal fraud and abuse laws, but stakeholders GAO spoke with reported that the laws, regulations, and agency guidance have created challenges for program design and implementation. The Stark law and anti-kickback statute, which restrict financial relationships among providers, have statutory and regulatory exceptions and s...
Private Health Insurance: Estimates of Individuals with Pre-Existing Conditions Range from 36 Million to 122 Million
GAO-12-439: Published: Mar 27, 2012. Publicly Released: Apr 26, 2012.
Hypertension was the most commonly reported medical condition among adults that could result in a health insurer denying coverage, requiring higher-than-average premiums, or restricting coverage. GAOs analysis found that about 33.2 million adults age 19-64 years old, or about 18 percent, reported hypertension in 2009. Individuals with hypertension reported average annual expenditures related...
Medicare: Important Steps Have Been Taken, but More Could Be Done to Deter Fraud
GAO-12-671T: Published: Apr 24, 2012. Publicly Released: Apr 24, 2012.
The Centers for Medicare & Medicaid Services (CMS)the agency that administers Medicarehas made progress in implementing several key strategies GAO identified in prior work as helpful in protecting Medicare from fraud; however, some actions that could help combat fraud remain incomplete.Provider Enrollment: GAOs previous work found persistent weaknesses in Medicares enrollme...
DOD Health Care: Cost Impact of Health Care Reform and the Extension of Dependent Coverage
GAO-11-837R: Published: Sep 26, 2011. Publicly Released: Sep 26, 2011.
The Department of Defense (DOD) offers health care to eligible beneficiaries through TRICARE, its health care program. Recently enacted health care reform legislation--the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA)--has implications for much of the nation's health care system, including TRICARE. One particular health refo...
Drug Pricing: Manufacturer Discounts in the 340B Program Offer Benefits, but Federal Oversight Needs Improvement
GAO-11-836: Published: Sep 23, 2011. Publicly Released: Sep 23, 2011.
The Health Resources and Services Administration (HRSA), within in the Department of Health and Human Services (HHS), oversees the 340B Drug Pricing Program, through which participating drug manufacturers give certain entities within the health care safety net--known as covered entities--access to discounted prices on outpatient drugs. Covered entities include specified federal grantees and hospit...
Patient Protection and Affordable Care Act: IRS Should Expand Its Strategic Approach to Implementation
GAO-11-719: Published: Jun 29, 2011. Publicly Released: Jun 29, 2011.
This report discusses the briefing we gave on June 8, 2011, as well as subsequent comments from the Internal Revenue Service (IRS). We gave this briefing in response to Congressional request that we assess IRS's planning to implement its responsibilities under the Patient Protection and Affordable Care Act (PPACA). The report (1) describes IRS's PPACA responsibilities and effective dates and (2) a...