Health care programs (51 - 60 of 122 items)
Medicare Subvention Demonstration: DOD Experience and Lessons for Possible VA Demonstration
T-HEHS/GGD-99-119: Published: May 4, 1999. Publicly Released: May 4, 1999.
Pursuant to a congressional request, GAO discussed the Department of Defense's (DOD) Medicare subvention demonstration program, focusing on: (1) the early phases of implementing the DOD demonstration; (2) issues raised by that experience for DOD subvention; and (3) lessons from the DOD demonstration for a possible Department of Veterans Affairs (VA) demonstration.GAO noted that: (1) subvention hol...
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...
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...
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...
Health Financing and Systems Issues: Issue Area Plan for Fiscal Years 1999-2001
IAP-98-13: Published: Jun 1, 1998. Publicly Released: Jun 1, 1998.
GAO provided information on its Health Financing and Systems issue area plan for fiscal years 1999-2001.GAO plans to examine: (1) how effectively the Health Care Financing Administration is managing Medicare's fee-for-service and managed care components--particularly the implementation of recent legislative reforms; (2) how payment and pricing reforms will be implemented and what effect they might...
Medicare Billing: Commercial System Could Save Hundreds of Millions Annually
AIMD-98-91: Published: Apr 15, 1998. Publicly Released: May 19, 1998.
Pursuant to a congressional request, GAO reviewed whether the Health Care Financing Administration (HCFA) used an adequate methodology for testing the commercial claims auditing system for potential nationwide implementation with its Medicare claims processing system.GAO noted that: (1) the test methodology HCFA used in Iowa was consistent with the approach used by other public health care insurer...
Medicare: Need to Overhaul Costly Payment System for Medical Equipment and Supplies
HEHS-98-102: Published: May 12, 1998. Publicly Released: May 15, 1998.
Pursuant to a congressional request, GAO reviewed Medicare's payments for commonly purchased, off-the-shelf durable medical equipment (DME), focusing on the need to: (1) better identify products billed to Medicare; and (2) bring Medicare fees more in line with current marketplace prices.GAO noted that: (1) there are two underlying problems with Medicare's DME payment system; (2) the Health Care Fi...
Medicare Fraud and Abuse: Summary and Analysis of Reforms in the Health Insurance Portability and Accountability Act of 1996 and the Balanced Budget Act of 1997
HEHS-98-18R: Published: Oct 9, 1997. Publicly Released: Oct 9, 1997.
Pursuant to a congressional request, GAO: (1) summarized the anti-fraud and abuse reforms enacted in the Health Insurance Portability and Accountability Act (HIPAA) and Balanced Budget Act (BBA); and (2) determined whether and how the legislation responds to GAO recommendations and those of the Department of Health and Human Services (HHS) Inspector General.GAO noted that: (1) the provisions in HI...
Medicaid: Three States' Experiences in Buying Employer-Based Health Insurance
HEHS-97-159: Published: Jul 25, 1997. Publicly Released: Aug 26, 1997.
Pursuant to a congressional request, GAO examined selected states considered to be successful in implementing section 1906 of the Social Security Act, focusing on: (1) the extent to which these states are purchasing employer-based health insurance for Medicaid-eligible individuals and achieving budgetary savings, as well as the potential for greater savings; (2) the cost-effectiveness criteria the...
Private Health Insurance: Continued Erosion of Coverage Linked to Cost Pressures
HEHS-97-122: Published: Jul 24, 1997. Publicly Released: Jul 24, 1997.
Pursuant to a congressional request, GAO reviewed major trends in the private health insurance market, during the 1980s and 1990s, focusing on: (1) the decline in private health insurance coverage and factors contributing to this decline; (2) trends in health insurance premiums and reasons for these trends; and (3) employer's efforts to control health benefits costs.GAO noted that: (1) private hea...