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Defense Health Care: Reimbursement of Hospitals Not Meeting CHAMPUS Copayment Requirements

HRD-88-102 Published: Jun 01, 1988. Publicly Released: Jun 01, 1988.
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Highlights

Pursuant to a legislative requirement, GAO reviewed Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) payment procedures for hospitals that failed to require patients to pay for their medical services.

Recommendations

Matter for Congressional Consideration

Matter Status Comments
Congress should enact legislation to authorize the Secretary of Defense to use CHAMPUS funds to reimburse hospitals that do not bill patients for copayments. The legislation should require that hospitals seeking such an exemption: (1) apply to the Department of Defense; and (2) as a minimum, meet the exempting criteria.
Closed – Implemented
The fiscal year (FY) 1989 DOD authorization and appropriations acts contained language which essentially implemented this recommendation.

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Topics

Billing proceduresFinancial managementHealth care costsHealth care programsHealth care servicesHealth insuranceHealth insurance cost controlHospitalsMedical feesMedicareDeductibles and Coinsurance