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Department of Health and Human Services, Executive (21 - 30 of 808 items)
Generic Drugs Under Medicare: Part D Generic Drug Prices Declined Overall, but Some Had Extraordinary Price Increases
GAO-16-706: Published: Aug 12, 2016. Publicly Released: Sep 12, 2016.
Generic drug prices declined overall under Medicare Part D—the voluntary outpatient prescription drug program administered by the Centers for Medicare & Medicaid Services within the Department of Health and Human Services (HHS)—since 2010. Specifically, generic drug prices fell 59 percent from the first quarter of 2010 through the second quarter of 2015. This decline reflects a changing basket...
Patient Protection and Affordable Care Act: Final Results of Undercover Testing of the Federal Marketplace and Selected State Marketplaces for Coverage Year 2015
GAO-16-792: Published: Sep 9, 2016. Publicly Released: Sep 12, 2016.
Under the Patient Protection and Affordable Care Act (PPACA), health-insurance marketplaces are required to verify application information to determine eligibility for enrollment and, if applicable, determine eligibility for income-based subsidies or Medicaid. Verification steps include reviewing and validating an applicant's Social Security number, if one is provided; citizenship, status as a U.S...
Foster Care: Most Tribes Do Not Anticipate Challenges with Case Goal Changes, but HHS Could Further Promote Guardianship Assistance
GAO-16-625: Published: Aug 8, 2016. Publicly Released: Sep 7, 2016.
To receive federal child welfare funding, state and tribal child welfare agencies must comply with certain requirements, including developing a permanency plan for the child that identifies how the child will exit the foster care system to a permanent home (“case goal”). If other case goals, such as reunifying with parents, adoption, or guardianship are not possible or appropriate, a child may...
Patient Protection and Affordable Care Act: Information on Approval Process for State Innovation Waivers
GAO-16-637R: Published: Jul 6, 2016. Publicly Released: Aug 5, 2016.
The Departments of Health and Human Services (HHS) and Treasury (Treasury; referred to together as the Departments) have established a number of controls in their process for approving state proposals to waive certain provisions of the Patient Protection and Affordable Care Act (PPACA), referred to as 1332 waivers. These controls seek to ensure that approved waivers meet the statutory criteria of...
Medicare Fee-For-Service: Opportunities Remain to Improve Appeals Process
GAO-16-366: Published: May 10, 2016. Publicly Released: Jun 9, 2016.
The appeals process for Medicare fee-for-service (FFS) claims consists of four administrative levels of review within the Department of Health and Human Services (HHS), and a fifth level in which appeals are reviewed by federal courts. Appeals are generally reviewed by each level sequentially, as appellants may appeal a decision to the next level depending on the prior outcome. Under the administr...
Higher Education: Actions Needed to Improve Access to Federal Financial Assistance for Homeless and Foster Youth
GAO-16-343: Published: May 19, 2016. Publicly Released: May 19, 2016.
Available research suggests that a lower percentage of youth who have been in foster care enroll in and complete college compared to other youth, but little is known about homeless youth. While the Departments of Education (Education) and Health and Human Services (HHS) administer programs that can help them with college, Education data from 2009 (the latest available) indicate that a lower percen...
Medicaid and CHIP: Increased Funding in U.S. Territories Merits Improved Program Integrity Efforts
GAO-16-324: Published: Apr 8, 2016. Publicly Released: May 9, 2016.
Eligibility and benefits for Medicaid and the state Children's Health Insurance Program (CHIP) in five U.S. territories—American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico and the U. S. Virgin Islands—differ from one another and from the states, generally reflecting the territories' unique circumstances. For example, Guam is the only territory that covers all...
Unaccompanied Children: HHS Should Improve Monitoring and Information Sharing Policies to Enhance Child Advocate Program Effectiveness
GAO-16-367: Published: Apr 19, 2016. Publicly Released: Apr 19, 2016.
In fiscal year 2015, the Department of Health and Human Services' (HHS) Office of Refugee Resettlement (ORR) expanded the child advocate program from two locations to five and added three more locations in fiscal year 2016. The child advocate program—operated by a contractor—was developed in 2004 to promote the best interests of especially vulnerable unaccompanied children in ORR custody. Advo...
Medicaid: Federal Guidance Needed to Address Concerns About Distribution of Supplemental Payments
GAO-16-108: Published: Feb 5, 2016. Publicly Released: Mar 7, 2016.
Not all selected hospitals in the four states GAO reviewed tracked their use of revenues from the large supplemental payments they received and tracking of revenues is generally not required. Based on information obtained from hospital officials and a review of demonstration approval documents, GAO determined that the revenues were used for a broad range of purposes. For example,Officials from nin...
Nonemergency Medical Transportation: Updated Medicaid Guidance Could Help States
GAO-16-238: Published: Feb 2, 2016. Publicly Released: Mar 3, 2016.
The nonemergency medical transportation (NEMT) benefits offered by Medicare and Medicaid differ. Medicare provides NEMT via ambulance only when other means of transportation, such as a taxi or wheelchair van, would jeopardize the health of the beneficiary. Medicaid NEMT is generally available for beneficiaries who have no other means of transportation to medical services. States are responsible fo...