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Other, Department of Health and Human Services, Executive (81 - 90 of 109 items)
Medicare Home Health Agencies: Closures Continue, With Little Evidence Beneficiary Access Is Impaired
HEHS-99-120: Published: May 26, 1999. Publicly Released: May 26, 1999.
Pursuant to a congressional request, GAO provided information on the: (1) distribution of Medicare home health agencies' (HHA) closures across urban and rural counties and the characteristics of closed agencies; and (2) effect of closures on beneficiary access to home health services.GAO noted that: (1) prior to the HHA closures that have attracted widespread attention, both the number of HHAs and...
Medicare: Early Evidence of Compliance Program Effectiveness Is Inconclusive
HEHS-99-59: Published: Apr 15, 1999. Publicly Released: Apr 15, 1999.
Pursuant to a congressional request, GAO reviewed the compliance programs established by health care providers to reduce improper payments by Medicare, focusing on the: (1) prevalence of compliance programs among hospitals and other Medicare providers; (2) costs involved with compliance programs; and (3) effectiveness of the programs, to the extent that could be measured.GAO noted that: (1) althou...
Medical Records Privacy: Access Needed for Health Research, but Oversight of Privacy Protections Is Limited
HEHS-99-55: Published: Feb 24, 1999. Publicly Released: Feb 24, 1999.
Pursuant to a congressional request, GAO reviewed the types of health research conducted outside the Common Rule and Federal Drug Administration (FDA) regulations, focusing on: (1) examining how medical information is used for research and the need for personally identifiable information; (2) identifying research that is and is not subject to current federal oversight requirements; (3) examining h...
Major Management Challenges and Program Risks: Department of Health and Human Services
OCG-99-7: Published: Jan 1, 1999. Publicly Released: Jan 1, 1999.
As part of its Performance and Accountability Series, GAO provided information on the major management challenges and program risks facing the Department of Health and Human Services (HHS).GAO noted that: (1) coordinating the efforts of the numerous administrators of HHS' programs, including its 11 agencies and state and local governments, is critical to ensuring program efficiency and effectivene...
Use of False Claims Act for Medicare Outpatient Claims Cases
B-279893: Published: Jul 22, 1998. Publicly Released: Aug 26, 1998.
Pursuant to a congressional request, GAO addressed a number of issues concerning the Department of Health and Human Services' (HHS) and the Department of Justice's (DOJ) enforcement of the False Claims Act against hospitals submitting improper Medicare claims for outpatient services. GAO held that: (1) there was no evidence that errors hospitals made with respect to HHS' and DOJ's 72-hour rule wer...
Medicare: Interim Payment System for Home Health Agencies
T-HEHS-98-234: Published: Aug 6, 1998. Publicly Released: Aug 6, 1998.
GAO discussed: (1) the rise in Medicare spending for home health services and the reasons for this growth; (2) the objectives of the home health interim payment system enacted by the Balanced Budget Act of 1997; and (3) concerns about the level and distribution of home health payments.GAO noted that: (1) a well-designed prospective payment system will provide the Medicare program with the best mea...
Medicare: HCFA's Use of Anti-Fraud-and-Abuse Funding and Authorities
HEHS-98-160: Published: Jun 1, 1998. Publicly Released: Jun 1, 1998.
Pursuant to a legislative requirement, GAO reviewed: (1) the Health Care Financing Administration's (HCFA) progress in implementing the Medicare Integrity Program; (2) what additional resources and authorities Congress provided to HCFA through the Medicare Integrity Program; (3) how HCFA has made use of these resources and authorities to improve the protection of Medicare funds; and (4) how HCFA p...
Medicare Home Health Benefit: Congressional and HCFA Actions Begin to Address Chronic Oversight Weaknesses
T-HEHS-98-117: Published: Mar 19, 1998. Publicly Released: Mar 19, 1998.
GAO discussed Medicare benefit fraud and abuse in the home health industry, focusing on: (1) the general nature of beneficiary eligibility criteria; (2) the diminished Medicare contractor review and audit effort; (3) weaknesses in Medicare's home health provider certification processes; and (4) new tools Congress provided to strengthen oversight of the home health benefit.GAO noted that: (1) sever...
Medicare: Improper Activities by Mid-Delta Home Health
OSI-98-5: Published: Mar 12, 1998. Publicly Released: Mar 19, 1998.
Pursuant to a congressional request, GAO investigated allegations of Medicare improprieties by home health care provider Mid-Delta Home Health of Belzoni, Mississippi, and affiliated companies, focusing on allegations that Mid-Delta: (1) routinely requested and received leave or bonuses back from its employees while charging Medicare their full amount; (2) paid the owner's daughter a full-time sal...
Medicare Home Health: Differences in Service Use by HMO and Fee-for-Service Providers
HEHS-98-8: Published: Oct 21, 1997. Publicly Released: Nov 20, 1997.
GAO provided information on home health services provided by Medicare health maintenance organizations (HMO), focusing on: (1) how Medicare HMOs provide and manage home health services, as compared to fee-for-service providers; and (2) what is known about the appropriateness of home health services provided to HMO enrollees, especially to vulnerable populations.GAO noted that: (1) since the late 1...