Health insurance cost control (71 - 80 of 407 items)
Medicaid: Federal and State Leadership Needed to Control Fraud And Abuse
T-HEHS-00-30: Published: Nov 9, 1999. Publicly Released: Nov 9, 1999.
Pursuant to a congressional request, GAO discussed ways to combat fraud and abuse in the Medicaid program, focusing on: (1) an overview of the problem; (2) key components of fraud control; and (3) the importance of federal and state cooperation.GAO noted that: (1) GAO's body of work on health care fraud and abuse indicates that programs the size and structure of Medicaid are inherently vulnerable...
Medicare: Outpatient Rehabilitation Therapy Caps Are Important Controls But Should Be Adjusted for Patient Need
HEHS-00-15R: Published: Oct 8, 1999. Publicly Released: Oct 8, 1999.
Pursuant to a congressional request, GAO provided information on the: (1) rationale for imposing per-beneficiary limits on Medicare's coverage of rehabilitation therapy services; and (2) effect of the therapy caps on Medicare beneficiaries' access to needed care.GAO noted that: (1) the per-beneficiary caps on coverage of outpatient rehabilitation therapy services are part of a larger effort by Con...
Medicare: Better Information Can Help Ensure That Refinements to BBA Reforms Lead to Appropriate Payments
T-HEHS-00-14: Published: Oct 1, 1999. Publicly Released: Oct 1, 1999.
Pursuant to a congressional request, GAO discussed the effects of the Balanced Budget Act of 1997 (BBA) on the Medicare program, focusing on the effects on three providers of post-acute care services--home health agencies (HHA), skilled nursing facilities (SNF), and providers of outpatient rehabilitation therapy--and on the health plans participating in the Medicare Choice program.GAO noted that:...
Skilled Nursing Facilities: Medicare Payments Need to Better Account for Nontherapy Ancillary Cost Variation
HEHS-99-185: Published: Sep 30, 1999. Publicly Released: Sep 30, 1999.
Pursuant to a congressional request, GAO provided information on the Medicare payments for skilled nursing facilities' (SNF) services under the new prospective payment system (PPS), focusing on: (1) whether the SNF payment rates incorporate the costs of nontherapy ancillary services; and (2) an analysis of the PPS design and nontherapy ancillary cost variation to assess whether payments are distri...
Medicare: Beneficiaries' Prescription Drug Coverage
T-HEHS-99-198: Published: Sep 28, 1999. Publicly Released: Sep 28, 1999.
Pursuant to a congressional request, GAO discussed Medicare beneficiaries' access to prescription drug coverage, focusing on: (1) how growth in presciption drug spending for both the general population and Medicare beneficiaries has made coverage such an important policy issue; (2) the sources and extent of Medicare beneficiary drug coverage; and (3) benefit design and implementation issues to be...
Medicare Subvention Demonstration: DOD Start-Up Overcame Obstacles, Yields Lessons, and Raises Issues
GGD/HEHS-99-161: Published: Sep 28, 1999. Publicly Released: Sep 28, 1999.
Pursuant to a legislative requirement, GAO provided information on the Department of Defense's (DOD) implementation of its Medicare Subvention Demonstration program, focusing on: (1) progress in establishing the ground rules for program operation, receiving Health Care Financing Administration (HCFA) approval, attracting enrollment, and starting to deliver health services; (2) the useful practices...
Private Health Insurance: Estimates of Effects of Health Insurance Tax Credits and Deductions as Proposed in H.R. 2261
HEHS-99-188R: Published: Sep 13, 1999. Publicly Released: Sep 27, 1999.
Pursuant to a congressional request, GAO provided information on the health insurance tax credit proposed in H.R. 2261 for individuals who purchased private health insurance, focusing on both the number of people who would potentially be eligible for a tax credit or deduction under this proposal and the potential value of these credits and deductions.GAO noted that: (1) if H.R. 2261 had been the l...
VA Health Care: Collections Fall Short of Expectations
T-HEHS-99-196: Published: Sep 23, 1999. Publicly Released: Sep 23, 1999.
Pursuant to a congressional request, GAO discussed the Department of Veterans Affairs' (VA) efforts to increase revenues from alternative sources as a way to supplement its medical care appropriations, focusing on trends in third-party collections.GAO noted that: (1) VA's third-party collections have declined in each of the past 3 fiscal years and may decline again by the end of fiscal year (FY) 1...
Medicare Reform: Ensuring Fiscal Sustainability While Modernizing the Program Will be Challenging
T-HEHS/AIMD-99-294: Published: Sep 22, 1999. Publicly Released: Sep 22, 1999.
Pursuant to a congressional request, GAO discussed efforts to reform the administration, structure, and financing of the Medicare program.GAO noted that: (1) in March, the Bipartisan Commission on the Future of Medicare completed its deliberations; (2) reform options emerged from these discussions that touched on all aspects of the Medicare program, including: (a) modernization of the traditional...
Medicare Fraud and Abuse: DOJ's Implementation of False Claims Act Guidance in National Initiatives Varies
HEHS-99-170: Published: Aug 6, 1999. Publicly Released: Aug 6, 1999.
Pursuant to a legislative requirement, GAO reviewed the Department of Justice's (DOJ) and selected U.S. Attorneys' Offices' implementation of the False Claims Act guidance, focusing on: (1) the status of DOJ's work groups efforts and the initiative-specific guidance they prepared; (2) DOJ's efforts to assess U.S. Attorneys' compliance with the guidance; (3) the implementation of the guidance at se...