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Offices, Department of Health and Human Services, Executive (101 - 110 of 198 items)
Medicaid and SCHIP: States Use Varying Approaches to Monitor Children's Access to Care
GAO-03-222: Published: Jan 14, 2003. Publicly Released: Feb 14, 2003.
Over 25 million children have health insurance coverage through Medicaid or the State Children's Health Insurance Program (SCHIP). Coverage alone, however, does not guarantee that services will be available or that children will receive needed care. GAO was asked to evaluate states' efforts to facilitate and monitor access to primary and preventive services for children in these jointly funded fed...
Skilled Nursing Facilities: Medicare Payments Exceed Costs for Most but Not All Facilities
GAO-03-183: Published: Dec 31, 2002. Publicly Released: Dec 31, 2002.
This report addresses (1) the relationship between Medicare skilled nursing facility (SNF) payments and the costs of treating Medicare patients in freestanding SNFs, as well as the effect of Medicare SNF payments on the financial condition of these facilities, and (2) the relationship between Medicare SNF payments and the costs of treating patients in hospital-based SNFs, as well as the factors th...
Information Technology Services: Agencies Complying with Revision to Federal Acquisition Regulation
GAO-03-32: Published: Dec 18, 2002. Publicly Released: Dec 18, 2002.
Concerned that minimum personnel experience or education requirements in agency solicitations for information technology (IT) services were contributing to worker shortages, Congress included a provision in the fiscal year 2001 Defense authorization act requiring that the Federal Acquisition Regulation (FAR) be amended to limit the use of such requirements. Specifically, agencies are not to inclu...
Bone Marrow Transplants: Despite Recruitment Successes, National Program May Be Underutilized
GAO-03-182: Published: Oct 18, 2002. Publicly Released: Oct 18, 2002.
More than 30,000 people are diagnosed annually with leukemia or other blood, metabolic, or immune system disorders, many of whom may die without stem cell transplants, using stem cells from bone marrow or another source. When a patient needs a transplant of donated stem cells and no genetically compatible related donor is available, the National Bone Marrow Donor Registry may help the patient sear...
Skilled Nursing Facilities: Providers Have Responded to Medicare Payment System By Changing Practices
GAO-02-841: Published: Aug 23, 2002. Publicly Released: Aug 23, 2002.
In 1998, the Health Care Financing Administration implemented a prospective payment system (PPS) for skilled nursing facility (SNF) services provided to Medicare beneficiaries. PPS is intended to control the growth in Medicare spending for skilled nursing and rehabilitative services that SNFs provide. Two years after the implementation of PPS, the mix of patients across the categories of payment g...
Welfare Reform: With TANF Flexibility, States Vary in How They Implement Work Requirements and Time Limits
GAO-02-770: Published: Jul 5, 2002. Publicly Released: Jul 5, 2002.
Congress created the Temporary Assistance for Needy Families (TANF) block grant to replace the previous welfare program and help welfare recipients transition into employment. To this end, states are required to enforce work requirements, and face financial penalties if a minimum percentage of adults receiving cash assistance do not participate in work or work-related activities each year. This fe...
Medicare: Health Care Fraud and Abuse Control Program for Fiscal Years 2000 and 2001
GAO-02-731: Published: Jun 3, 2002. Publicly Released: Jun 3, 2002.
The Medicare program is the nation's largest health insurer with almost 40 million beneficiaries and outlays of over $219 billion annually. Because of the susceptibility of the program to fraud and abuse, Congress enacted the Health Care Fraud and Abuse Control (HCFAC) Program as part of the Health Insurance Portability and Accountability Act (HIPPAA) of 1996. HCFAC, which is administered by the D...
Medicare: Using Education and Claims Scrutiny to Minimize Physician Billing Errors
GAO-02-778T: Published: May 28, 2002. Publicly Released: May 28, 2002.
In its audit for year 2001, the Department of Health and Human Services' Office of Inspector General found that $12.1 billion was improperly paid to Medicare providers. GAO's February report (GAO-02-249) showed that physicians often do not receive complete, accurate, clear, or timely guidance on Medicare billing and payment policies. At the carriers studied, GAO found significant shortcomings in p...
Medicare: Orthotics Ruling Has Implications for Beneficiary Access and Federal and State Costs
GAO-02-330: Published: May 22, 2002. Publicly Released: May 22, 2002.
In the late 1980s and early 1990s, the Health Care Financing Administration (HCFA), now called the Centers for Medicare and Medicaid Services (CMS), became concerned that some suppliers were improperly billing Medicare for items that attach to wheelchairs and other equipment. Some suppliers were billing for such items using codes for orthodic devices, including arm, back, and neck braces that prov...
Children's Health Insurance: Inspector General Reviews Should Be Expanded to Further Inform the Congress
GAO-02-512: Published: Mar 29, 2002. Publicly Released: Mar 29, 2002.
Congress created the State Children's Health Insurance Program (SCHIP) in 1997 to reduce the number of uninsured children in families with incomes that are too high to qualify for Medicaid. Financed jointly by the states and the federal government, SCHIP encourages state participation by offering a higher federal matching rate than the Medicaid program. Concerns have been raised that states might...