Medicaid services (1 - 3 of 3 items) in Past 6 Months
Private Health Insurance: In Most States and New Exchanges, Enrollees Continued to be Concentrated among Few Issuers in 2014 [Reissued on February 14, 2017]
GAO-16-724: Published: Sep 6, 2016. Publicly Released: Sep 6, 2016.
GAO found that enrollment in private health insurance plans remained concentrated among a small number of issuers in most states in 2014, including in the newly established exchanges. On average in each state and the District of Columbia, 11 or more issuers participated in each of three types of markets—individual, small group, and large group—from 2011 through 2014. However, in most states, t...
Medicare Advantage: Limited Progress Made to Validate Encounter Data Used to Ensure Proper Payments
GAO-17-223: Published: Jan 17, 2017. Publicly Released: Jan 19, 2017.
Since GAO issued its July 2014 report, the Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) has made limited progress to validate the completeness and accuracy of Medicare Advantage (MA) encounter data. CMS collects encounter data—detailed information about the care and health status of MA enrollees—to determine payments to MA organization...
Medicaid: Key Policy and Data Considerations for Designing a Per Capita Cap on Federal Funding
GAO-16-726: Published: Aug 10, 2016. Publicly Released: Sep 9, 2016.
Through review of its prior reports, the literature and interviews with state Medicaid officials and subject matter experts, GAO identified several key interrelated policy considerations that could be useful should policymakers elect to pursue a per capita cap—a per-enrollee limit on federal Medicaid funding for states.Coverage and flexibility. Coverage entails decisions about whether all or a s...