Beneficiaries (21 - 30 of 45 items)
Medicaid Demonstration Waivers: Lack of Opportunity for Public Input during Federal Approval Process Still a Concern
GAO-07-694R: Published: Jul 24, 2007. Publicly Released: Aug 23, 2007.
States provide health care coverage to about 60 million low-income individuals through Medicaid, a joint federal and state program established under title XIX of the Social Security Act (the Act). Title XIX of the Act established parameters under which states operate their Medicaid programs, such as requiring states to cover certain services for certain mandatory groups of individuals such as low-...
TRICARE: Changes to Access Policies and Payment Rates for Services Provided by Civilian Obstetricians
GAO-07-941R: Published: Jul 31, 2007. Publicly Released: Jul 31, 2007.
About 111,000 women covered by the Department of Defense's (DOD) TRICARE program gave birth during 2006. During their pregnancies, about half of these women received obstetric care from physicians and other providers practicing at military hospitals and clinics called military treatment facilities (MTF), while half received their care from civilian physicians and other civilian providers. In recen...
Medicaid: States Reported That Citizenship Documentation Requirement Resulted in Enrollment Declines for Eligible Citizens and Posed Administrative Burdens
GAO-07-889: Published: Jun 28, 2007. Publicly Released: Jul 25, 2007.
The Deficit Reduction Act of 2005 (DRA) included a provision that requires states to obtain documentary evidence of U.S. citizenship or nationality when determining eligibility of Medicaid applicants and current beneficiaries; self-attestation of citizenship and nationality is no longer acceptable. The Centers for Medicare & Medicaid Services (CMS) issued regulations states must follow in obtainin...
Retiree Health Benefits: Majority of Sponsors Continued to Offer Prescription Drug Coverage and Chose the Retiree Drug Subsidy
GAO-07-572: Published: May 31, 2007. Publicly Released: May 31, 2007.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) created a prescription drug benefit for beneficiaries, called Medicare Part D, beginning in January 2006. The MMA resulted in options for sponsors of employment-based prescription drug benefits, such as a federal subsidy payment--the retiree drug subsidy (RDS)--when sponsors provide benefits meeting certain MMA requir...
Medicare Part D Low-Income Subsidy: Progress Made in Approving Applications, but Ability to Identify Remaining Individuals Is Limited
GAO-07-858T: Published: May 8, 2007. Publicly Released: May 8, 2007.
To help the elderly and disabled with prescription drug costs, the Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, which created a voluntary outpatient prescription drug benefit (Medicare Part D). A key element of the prescription drug benefit is the low-income subsidy, or "extra help," available to Medicare beneficiaries with limited income and re...
Prescription Drugs: Oversight of Drug Pricing in Federal Programs
GAO-07-481T: Published: Feb 9, 2007. Publicly Released: Feb 9, 2007.
Several federal programs help pay for or reduce the costs of prescription drugs for eligible individuals and entities. Three examples are the Medicaid drug rebate program, part of the joint federal-state Medicaid program that finances medical services for certain low-income people; the 340B drug pricing program, which provides discounted drug prices to certain eligible entities such as community h...
Medicaid Outpatient Drugs: Estimated 2007 Federal Upper Limits for Reimbursement Compared with Retail Pharmacy Acquisition Costs
GAO-07-239R: Published: Dec 22, 2006. Publicly Released: Jan 22, 2007.
Spending on outpatient prescription drugs in Medicaid--the joint federal-state program that finances medical services for certain low-income adults and children--has accounted for a substantial and growing share of Medicaid expenditures. Medicaid's total spending on outpatient prescription drugs grew from $4.6 billion in fiscal year 1990 to $40 billion in fiscal year 2004--or from 7.0 to 14.2 perc...
Medicare: Quality of CMS Communications to Beneficiaries on the Prescription Drug Benefit Could Be Improved
GAO-06-715T: Published: May 4, 2006. Publicly Released: May 4, 2006.
Today's hearing focuses on Medicare Part D, the program's new outpatient prescription drug benefit. On January 1, 2006, Medicare began providing this benefit, and beneficiaries have until May 15, 2006, to enroll without the risk of penalties. The Centers for Medicare & Medicaid Services (CMS), which administers the Part D benefit, has undertaken outreach and education efforts to inform beneficiari...
Medicare: Communications to Beneficiaries on the Prescription Drug Benefit Could Be Improved
GAO-06-654: Published: May 3, 2006. Publicly Released: May 3, 2006.
On January 1, 2006, Medicare began providing coverage for outpatient prescription drugs through its new Part D benefit. Beneficiaries who enroll in Part D may choose a drug plan from those offered by private plan sponsors under contract to the Centers for Medicare & Medicaid Services (CMS), which administers the Part D benefit. Beneficiaries have until May 15, 2006, to enroll in the Part D benefit...
Medicare: Sponsors' Management of the Prescription Drug Discount Card and Transitional Assistance Benefit
GAO-06-299R: Published: Jan 13, 2006. Publicly Released: Feb 21, 2006.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) added a prescription drug benefit to the Medicare program, which became effective January 1, 2006. To assist Medicare beneficiaries with their prescription drug costs until the new benefit became available, the MMA also required the establishment of a temporary program, the Medicare Prescription Drug Discount Card and...