Medicare: Status Report on Medicare Insured Group Demonstration Projects
HRD-89-64
Published: Jun 27, 1989. Publicly Released: Jun 27, 1989.
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Highlights
Pursuant to a legislative requirement, GAO: (1) monitored the status of the Health Care Financing Administration's (HCFA) implementation of the Medicare Insured Groups (MIG) demonstration group projects; and (2) reviewed the potential effects of the Omnibus Budget Reconciliation Act (OBRA) of 1987 requirements on the projects.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | The Secretary of Health and Human Services should require HCFA to apply the 95 percent of the experience-based rate payment limitation and the surplus retention restrictions of OBRA to all MIG projects. |
Closed – Implemented
The Department of Health and Human Services (HHS) instructed HCFA to apply the 95 percent of experience limitation to all MIG projects.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should require HCFA to define surplus as the excess of Medicare payments over the costs of providing Medicare-covered services. |
Closed – Implemented
HHS instructed HCFA to define surplus as the excess of Medicare payment over the costs of providing Medicare-covered services.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should require HCFA to require that all surplus over that amount either be used for additional benefits not previously funded by the employer or be returned to the Medicare program. |
Closed – Implemented
HHS instructed HCFA to require all surpluses to be used either for additional benefits not previously funded by the employer or be returned to Medicare.
|
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Topics
Employee medical benefitsHealth care cost controlHealth insurance cost controlHealth maintenance organizationsMedicarePrivate sectorPublic health legislationRetireesBeneficiariesMedicare payments