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Offices, Department of Health and Human Services, Executive (1 - 10 of 25 items)
Fiscal Outlook: Addressing Improper Payments and the Tax Gap Would Improve the Government's Fiscal Position
GAO-16-92T: Published: Oct 1, 2015. Publicly Released: Oct 1, 2015.
A number of strategies, including implementing preventive controls and addressing GAO's prior recommendations, can help agencies reduce improper payments, which have been a persistent, government-wide issue. The improper payment estimate, attributable to 124 programs across 22 agencies in fiscal year 2014, was $124.7 billion, up from $105.8 billion in fiscal year 2013. The almost $19 billion incre...
Health Care Fraud and Abuse Control Program: Indicators Provide Information on Program Accomplishments, but Assessing Program Effectiveness is Difficult
GAO-13-746: Published: Sep 30, 2013. Publicly Released: Oct 30, 2013.
In fiscal year 2012, the Department of Health and Human Services (HHS), HHS Office of Inspector General (HHS-OIG), and the Department of Justice (DOJ) obligated approximately $583.6 million to fund Health Care Fraud and Abuse Control (HCFAC) program activities. About 78 percent of obligated funds were from mandatory HCFAC appropriations (budgetary resources provided in laws other than appropriatio...
Health Care Fraud: Types of Providers Involved in Medicare Cases, and CMS Efforts to Reduce Fraud
GAO-13-213T: Published: Nov 28, 2012. Publicly Released: Nov 28, 2012.
In recently completed work, we found that medical facilities (such as medical centers, clinics, and practices) and durable medical equipment suppliers were the most frequent subjects of criminal fraud cases in Medicare, Medicaid, and CHIP in 2010. Hospitals and medical facilities were the most frequent subjects of civil fraud cases, including cases that resulted in judgments or settlements. Accord...
Health Care Fraud: Types of Providers Involved in Medicare, Medicaid, and the Children's Health Insurance Program Cases
GAO-12-820: Published: Sep 7, 2012. Publicly Released: Oct 9, 2012.
According to 2010 data from the Department of Health and Human Services' Office of the Inspector General (HHS-OIG) and the Department of Justice (DOJ), 10,187 subjects--individuals and entities involved in fraud cases--were investigated for health care fraud, including fraud in Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). These subjects included different types of provid...
Group Purchasing Organizations: Federal Oversight and Self-Regulation
GAO-12-399R: Published: Mar 30, 2012. Publicly Released: Apr 30, 2012.
GPOs are subject to certain federal laws that HHS, DOJ, and FTC are responsible for enforcing. According to HHS Office of Inspector General (HHS-OIG) officials, since 2004, the office has not routinely exercised its authority to request and review disclosures related to GPOs contract administrative fees, but it has collected information on GPOs contract administrative fees while conduc...
Medicare Contracting Reform: Agency Has Made Progress with Implementation, but Contractors Have Not Met All Performance Standards
GAO-10-71: Published: Mar 25, 2010. Publicly Released: Apr 26, 2010.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 significantly reformed contracting for payment of Medicare's $310 billion per year in fee-for-service claims. The Centers for Medicare & Medicaid Services (CMS) is transitioning claims administration to 19 new entities known as Medicare Administrative Contractors (MAC) and plans to complete the process ahead of October 1, 2...
Hurricane Katrina: Barriers to Mental Health Services for Children Persist in Greater New Orleans, Although Federal Grants Are Helping to Address Them
GAO-09-563: Published: Jul 13, 2009. Publicly Released: Jul 20, 2009.
The greater New Orleans area--Jefferson, Orleans, Plaquemines, and St. Bernard parishes--has yet to fully recover from the effects of Hurricane Katrina. As a result of the hurricane and its aftermath, many children experienced psychological trauma, which can have long-lasting effects. Experts have previously identified barriers to providing and obtaining mental health services for children. The De...
Methadone-Associated Overdose Deaths: Factors Contributing to Increased Deaths and Efforts to Prevent Them
GAO-09-341: Published: Mar 26, 2009. Publicly Released: Mar 31, 2009.
Prescription drug abuse is a growing public health problem. In particular, methadone-associated overdose deaths--those in which methadone may have caused or contributed to the death--have risen sharply. Before the late 1990s, methadone was used mainly to treat opioid addiction but has since been increasingly prescribed to manage pain. Taken too often, in too high a dose, or with other drugs or alc...
Young Adults With Serious Mental Illness: Some States and Federal Agencies Are Taking Steps to Address Their Transition Challenges
GAO-08-678: Published: Jun 23, 2008. Publicly Released: Jun 25, 2008.
The transition to adulthood can be difficult for young adults who suffer from a serious mental illness, such as schizophrenia or bipolar disorder. When these individuals are unsuccessful, the result can be economic hardship, social isolation, and in some cases suicide, all of which can pose substantial costs to society. Due to concerns about young adults with serious mental illness transitioning i...
Medicaid Program Integrity: State and Federal Efforts to Prevent and Detect Improper Payments
GAO-04-707: Published: Jul 16, 2004. Publicly Released: Aug 18, 2004.
During fiscal year 2002, Medicaid--a program jointly funded by the federal government and the states--provided health care coverage for about 51 million low-income Americans. That year, Medicaid benefit payments reached approximately $244 billion, of which the federal share was about $139 billion. The program is administered by state Medicaid agencies with oversight provided by the Centers for Med...