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Medicaid Requirements: Health Insuring Organizations

HRD-86-42FS Published: Nov 27, 1985. Publicly Released: Dec 27, 1985.
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Highlights

Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) regulations for contracts with health insuring organizations (HIO). HIO are entities that: (1) pay for medical services provided to recipients in exchange for fees paid by state Medicaid agencies; and (2) assume underwriting risks.

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Financial disclosureHealth care cost controlHealth care servicesHealth insuranceInsurance regulationProcurement regulationsReporting requirementsMedicaidHealth careFederal regulations