Medicare: Further Changes Needed to Reduce Program and Beneficiary Costs
HRD-91-67
Published: May 15, 1991. Publicly Released: Jun 14, 1991.
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Highlights
Pursuant to a congressional request, GAO provided information on Medicare's efforts to reduce its program and beneficiary costs.
Recommendations
Matter for Congressional Consideration
Matter | Status | Comments |
---|---|---|
Congress may wish to consider directing HCFA to test and assess alternative ways to market HMO that serve Medicare beneficiaries. Specifically, Congress could direct that HCFA conduct demonstrations to test-market HMO through independent third-party organizations operating under HCFA direction. |
Closed – Not Implemented
|
Congress has not yet taken action. Reforms for managed care initiatives are being considered in the context of broad-based health care reform. |
Congress should consider broadening HCFA sanction authority, for example, by authorizing civil monetary penalties when HMO do not comply with peer review organization review requirements. |
Closed – Not Implemented
|
Congress has not yet taken action. Reforms for managed care initiatives are being considered in the context of broad-based health care reform. |
Increasing funding for payment safeguard activities, and thereby preventing inappropriate program payments, could help lessen the need for the difficult across-the-board cuts to all providers that Congress is faced with annually. Consequently, Congress should consider appropriating additional funds for contractor safeguard activities. |
Closed – Implemented
|
Recently passed legislation (Health Insurance Portability and Accountability Act of 1996) provides new funding mechanisms for program safeguard activities. |
Because of the strong potential for a net reduction in federal spending, Congress should consider establishing a similar means of facilitating increased expenditures to fund Medicare administrative costs. |
Closed – Not Implemented
|
Several bills have been introduced to implement this recommendation, but none have been enacted. Given rigorous budgetary constraints and competing demands, Congress is not likely to enact this recommendation. |
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Topics
Health care cost controlHealth care servicesHealth maintenance organizationsHealth services administrationMedical services ratesMedicareOverpaymentsOversight committeesPhysiciansProgram evaluation