Health insurance cost control (71 - 80 of 267 items)
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...
Health Insurance Standards: Implications of New Federal Law for Consumers, Insurers, Regulators
T-HEHS-98-114: Published: Mar 19, 1998. Publicly Released: Mar 19, 1998.
Pursuant to a congressional request, GAO discussed the implementation of the private insurance market provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).GAO noted that: (1) although HIPAA gives people losing coverage a guarantee of access to coverage in the individual market, consumers attempting to exercise this right have been hindered in some states by carrier...
Health Insurance Standards: New Federal Law Creates Challenges for Consumers, Insurers, Regulators
HEHS-98-67: Published: Feb 25, 1998. Publicly Released: Mar 10, 1998.
Pursuant to a congressional request, GAO reviewed the implementation of the Health Insurance Portability and Accountability Act (HIPAA), focusing on issues affecting: (1) consumers; (2) issuers of health coverage, including employers and insurance carriers; (3) state insurance regulators; and (4) federal regulators. GAO also reviewed efforts undertaken by federal agencies to address some of the co...
Retiree Health Insurance: Erosion in Retiree Health Benefits Offered by Large Employers
T-HEHS-98-110: Published: Mar 10, 1998. Publicly Released: Mar 10, 1998.
GAO discussed the erosion in employer-based health benefits for retirees, especially early retirees, focusing on: (1) trends in access to employer-sponsored retiree health benefits; (2) the impact on retirees of an employer's decision to terminate health benefits; and (3) federal safeguards that protect the rights of retirees who have health benefits.GAO noted that: (1) retiree access to and parti...
Medigap Insurance: Compliance With Federal Standards Has Increased
HEHS-98-66: Published: Mar 6, 1998. Publicly Released: Mar 6, 1998.
Pursuant to a legislative requirement, GAO reviewed insurers' compliance with Medigap loss ratios and standards, focusing on: (1) the overall Medigap market; (2) which Medigap policies had loss ratios below the standards in 1994 and 1995; and (3) which policies resulted in refunds or credits, or, if not, why.GAO noted that: (1) from 1988 through 1995, the Medigap insurance market grew from $7 bill...
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...
Health Financing and Systems Issues Issue Area Plan--Fiscal Years 1998-2000
IAP-97-13: Published: Jul 1, 1997. Publicly Released: Jul 1, 1997.
GAO provided information on its Health Financing and Systems issue area plan for fiscal years 1998 to 2000.GAO plans to examine: (1) actions to improve the management and financial integrity of the Medicare and Medicaid programs; (2) new strategies for paying for Medicare and Medicaid services that promote cost containment while preserving quality and access; (3) how financing arrangements affect...
Medicare HMOs: Setting Payment Rates Through Competitive Bidding
HEHS-97-154R: Published: Jun 12, 1997. Publicly Released: Jun 12, 1997.
GAO reviewed the Health Care Financing Administration's (HCFA) proposed use of competitive bidding as an alternative method for setting Medicare health maintenance organization (HMO) payment rates, focusing on: (1) the potential advantages of competitive bidding in the Medicare HMO program; (2) the main features of HCFA's planned competitive bidding demonstration in Denver; and (3) HMO's key objec...