Health insurance cost control (91 - 100 of 407 items)
Medicare Home Health Agencies: Role of Surety Bonds in Increasing Scrutiny and Reducing Overpayments
HEHS-99-23: Published: Jan 29, 1999. Publicly Released: Mar 3, 1999.
Pursuant to a congressional request, GAO evaluated the surety bond requirements for home health agencies (HHA) participating in Medicare, focusing on: (1) analyzing the key features of surety bonds that affect their costs and effect; (2) examining the Florida Medicaid program's experience with a surety bond requirements for HHAs and its relevance to the Medicare surety bond requirement; (3) review...
Medical Savings Accounts: Results From Surveys of Insurers
HEHS-99-34: Published: Dec 31, 1998. Publicly Released: Dec 31, 1998.
Pursuant to a legislative requirement, GAO addressed the effects of medical savings accounts (MSA) on: (1) selection, including adverse selection; (2) health costs, including any new impact on premiums of individuals with comprehensive coverage; (3) use of preventive care; (4) consumer choice; (5) the scope of coverage on high-deductible plans purchased in conjunction with such accounts; and (6) o...
Medicare: Coverage of Pumps Used to Administer Intravenous Drugs
HEHS-99-16R: Published: Nov 16, 1998. Publicly Released: Dec 16, 1998.
Pursuant to a congressional request, GAO reviewed the advantages and disadvantages of providing Medicare coverage for disposable infusion pumps, focusing on: (1) the clinical benefits and limitations of disposable infusion pumps; (2) the factors that affect whether a durable or disposable infusion pump is less expensive to use for home infusion; (3) some Medicaid and private insurance plans' home...
HCFA: Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for 1999
OGC-99-9: Published: Nov 5, 1998. Publicly Released: Nov 5, 1998.
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on inpatient hospital deductible and hospital extended care services coinsurance amounts for 1999. GAO noted that: (1) the new rule would announce coinsurance amounts for services furnished in calendar year 1999 under Medicare's hospital insurance program; and (2) HCFA complied with appli...
Medicare Managed Care: Payment Rates, Local Fee-for-Service Spending, and Other Factors Affect Plans' Benefit Packages
HEHS-99-9R: Published: Oct 9, 1998. Publicly Released: Oct 9, 1998.
Pursuant to a congressional request, GAO provided information on Medicare's health maintenance organizations (HMO), focusing on: (1) the key differences between Medicare's traditional fee-for-service (FFS) and managed care programs; (2) how Medicare historically set the monthly capitation rates paid to managed care plans and why these rates varied among counties; (3) how the Balanced Budget Act of...
Use of False Claims Act for Medicare Outpatient Claims Cases
B-279893: Published: Jul 22, 1998. Publicly Released: Aug 26, 1998.
Pursuant to a congressional request, GAO addressed a number of issues concerning the Department of Health and Human Services' (HHS) and the Department of Justice's (DOJ) enforcement of the False Claims Act against hospitals submitting improper Medicare claims for outpatient services. GAO held that: (1) there was no evidence that errors hospitals made with respect to HHS' and DOJ's 72-hour rule wer...
Medicare: Application of the False Claims Act to Hospital Billing Practices
HEHS-98-195: Published: Jul 10, 1998. Publicly Released: Aug 10, 1998.
Pursuant to a congressional request, GAO reviewed: (1) the False Claims Act and its application to claims involving health care programs; (2) information on the data sources, analysis, and procedures used to bring False Claims Act cases against hospitals under the 72-Hour Window Project; and (3) similar information on the Lab Unbundling Project.GAO noted that: (1) the False Claims Act was original...
Private Health Insurance: Estimates of a Proposed Health Insurance Tax Credit for Those Who Buy Individual Health Insurance
HEHS-98-221R: Published: Jul 22, 1998. Publicly Released: Aug 3, 1998.
Pursuant to a congressional request, GAO provided information on the potential tax benefit that individuals without employment-based health coverage would receive if a tax credit were available for the premiums of individually purchased health insurance, focusing on the number of people who would possibly benefit from a tax credit and the potential value of the tax credit as proposed in H.R. 539.G...
Private Health Insurance: Impact of Premium Increases on the Number of Covered Individuals Is Uncertain
HEHS-98-203R: Published: Jul 7, 1998. Publicly Released: Jul 31, 1998.
Pursuant to a congressional request, GAO provided information on the relationship between the amount charged for private health insurance and the number of insured individuals, and the basis for a widely cited statistic from the Lewin Group that the number of insured individuals would fall by 400,000 for every 1-percent increase in health insurance premiums, focusing on: (1) trends in employers' d...
Employment-Based Health Insurance: Medium and Large Employers Can Purchase Coverage, but Some Workers Are Not Eligible
HEHS-98-184: Published: Jul 27, 1998. Publicly Released: Jul 27, 1998.
Pursuant to a legislative requirement, GAO reviewed the extent to which classes of large employers in different states have access to health insurance and the circumstances surrounding the lack of access, if any, to coverage, focusing on: (1) the extent to which medium and large employers in different categories and states have access to health insurance and the barriers, if any, these employers f...