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Department of Health and Human Services, Executive (61 - 70 of 808 items)
Group Purchasing Organizations: Funding Structure Has Potential Implications for Medicare Costs
GAO-15-13: Published: Oct 24, 2014. Publicly Released: Nov 24, 2014.
According to representatives from the 5 large group purchasing organizations (GPO) in GAO's review, GPO contracting generally involves three phases: (1) issue requests for proposals or invitations for vendors to competitively bid for a contract, (2) review proposals, and (3) negotiate and award contracts. GPOs reported negotiating and awarding different types of contracts to vendors in different s...
Health Care Transparency: Actions Needed to Improve Cost and Quality Information for Consumers
GAO-15-11: Published: Oct 20, 2014. Publicly Released: Nov 18, 2014.
Results obtained from two selected private consumer transparency tools GAO reviewed—websites with health cost or quality information comparing different health care providers—show that some providers are paid thousands of dollars more than others for the same service in the same geographic area, regardless of the quality of such services. For example, the cost for maternity care at selected ac...
Compounded Drugs: Payment Practices Vary across Public Programs and Private Insurers, and Medicare Part B Policy Should Be Clarified
GAO-15-85: Published: Oct 10, 2014. Publicly Released: Nov 10, 2014.
Medicare, Medicaid, and private health insurers have varying payment practices for compounded drugs, depending upon whether compounded drugs and their ingredients can be identified on health insurance claims, and Medicare's Part B payment policy for these drugs is unclear.For drugs dispensed in pharmacy settings, claims contain sufficient information for public programs and private insurers to ide...
Private Health Insurance: The Range of Base Premiums in the Individual Market by County in January 2013
GAO-14-772R: Published: Sep 5, 2014. Publicly Released: Oct 6, 2014.
GAO is reporting the range of base premiums prior to underwriting for individual market health insurance plans as displayed on the HealthCare.gov Plan Finder in January 2013 for every county in each of the 50 states and the District of Columbia. The base premiums reflected information from data submitted by insurers to the...
Healthcare.gov: Information Security and Privacy Controls Should Be Enhanced to Address Weaknesses
GAO-14-871T: Published: Sep 18, 2014. Publicly Released: Sep 18, 2014.
Enrollment through Healthcare.gov is supported by the exchange of information among many systems and entities. The Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS) has overall responsibility for key information technology (IT) systems supporting Healthcare.gov. These include, among others, the Federally Facilitated Marketplace (FFM) system, which facili...
Health Insurance Exchanges: Coverage of Non-excepted Abortion Services by Qualified Health Plans
GAO-14-742R: Published: Sep 15, 2014. Publicly Released: Sep 16, 2014.
Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered in health insurance exchanges—known as qualified health plans (QHP)—may cover abortion services as a benefit consistent with federal and state law. Federal law applicable to QHPs for the 2014 benefit year prohibits the use of federal funds made available to offset the cost of QHP coverage to pay for abortion...
Medicaid Demonstrations: HHS's Approval Process for Arkansas's Medicaid Expansion Waiver Raises Cost Concerns
GAO-14-689R: Published: Aug 8, 2014. Publicly Released: Sep 8, 2014.
In approving Arkansas’s Medicaid Section 1115 demonstration, the Department of Health and Human Services (HHS) gave the state the authority to test whether providing premium assistance to purchase private coverage offered on the health insurance exchange will improve access to care for individuals newly eligible for Medicaid as a result of the Patient Protection and Affordable Care Act (PPACA).I...
World Trade Center Health Program: Approach Used to Add Cancers to List of Covered Conditions Was Reasonable, but Could Be Improved
GAO-14-606: Published: Jul 23, 2014. Publicly Released: Aug 22, 2014.
The Administrator of the World Trade Center Health Program (WTCHP)—a program of the Department of Health and Human Services (HHS)—used a hazard-based, multiple-method approach to determine whether to add cancers to the WTCHP list of covered conditions for which treatment may be provided at no cost to an enrollee. Experts who participated in a meeting held by GAO indicated that the Administrato...
Special Education: Additional Federal Actions Could Help Address Unique Challenges of Educating Children in Nursing Homes
GAO-14-585: Published: Jul 16, 2014. Publicly Released: Jul 16, 2014.
Children in nursing homes represent a relatively small group of children whose medically complex conditions often present unique educational challenges. Of the nearly 5,000 school-age children in nursing homes nationwide, about 40 percent needed a feeding tube for nutrition and one-third needed oxygen therapy to help them breathe, according to GAO's analysis of 2012 data—the most recent data ava...
Improper Payments: Government-Wide Estimates and Reduction Strategies
GAO-14-737T: Published: Jul 9, 2014. Publicly Released: Jul 9, 2014.
Federal agencies reported an estimated $105.8 billion in improper payments in fiscal year 2013, a decrease from the prior year revised estimate of $107.1 billion. The fiscal year 2013 estimate was attributable to 84 programs spread among 18 agencies. The specific programs included in the government-wide estimate may change from year to year. For example, with Office of Management and Budget (OMB)...