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Offices, Department of Health and Human Services, Executive (11 - 20 of 110 items)
Electronic Health Record Programs: Participation Has Increased, but Action Needed to Achieve Goals, Including Improved Quality of Care
GAO-14-207: Published: Mar 6, 2014. Publicly Released: Mar 6, 2014.
Based on the number of providers awarded incentive payments, participation in the Department of Health and Human Services' (HHS) Medicare and Medicaid Electronic Health Record (EHR) programs increased substantially from their first year in 2011 to 2012. For hospitals, participation increased from 45 percent of those eligible for 2011 to 64 percent of those eligible for 2012. For professionals, suc...
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...
Medicare: Higher Use of Costly Prostate Cancer Treatment by Providers Who Self-Refer Warrants Scrutiny
GAO-13-525: Published: Jul 19, 2013. Publicly Released: Aug 1, 2013.
The number of Medicare prostate cancer-related intensity-modulated radiation therapy (IMRT) services performed by self-referring groups increased rapidly, while declining for non-self-referring groups from 2006 to 2010. Over this period, the number of prostate cancer-related IMRT services performed by self-referring groups increased from about 80,000 to 366,000. Consistent with that growth, expend...
Indian Health Service: Capping Payment Rates for Nonhospital Services Could Save Millions of Dollars for Contract Health Services
GAO-13-272: Published: Apr 11, 2013. Publicly Released: Apr 11, 2013.
The Indian Health Service's (IHS) federal contract health services (CHS) programs primarily paid physicians at their billed charges, which were significantly higher than what Medicare and private insurers would have paid for the same services. IHS's policy states that federal CHS programs should purchase services from contracted providers at negotiated, reduced rates. However, of the almost $63 mi...
Prevention and Public Health Fund: Activities Funded in Fiscal Years 2010 and 2011
GAO-12-788: Published: Sep 13, 2012. Publicly Released: Oct 15, 2012.
For fiscal years 2010 and 2011, the Department of Health and Human Services (HHS) allocated funds from the Prevention and Public Health Fund (PPHF) for 43 activities in five agencies. These activitieswhich include HHS programs and initiativeswere administered by HHSs Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), Health Resour...
National Medicaid Audit Program: CMS Should Improve Reporting and Focus on Audit Collaboration with States
GAO-12-814T: Published: Jun 14, 2012. Publicly Released: Jun 14, 2012.
We found that, compared to the initial test audits and the more recent collaborative audits, the majority of the MIG audits conducted under NMAP were less effective because they used Medicaid Statistical Information System (MSIS) data. MSIS is an extract of states claims data and is missing key elements, such as provider names, that are necessary for identifying audit targets. Since fiscal y...
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...
Private Health Insurance: Estimates of Individuals with Pre-Existing Conditions Range from 36 Million to 122 Million
GAO-12-439: Published: Mar 27, 2012. Publicly Released: Apr 26, 2012.
Hypertension was the most commonly reported medical condition among adults that could result in a health insurer denying coverage, requiring higher-than-average premiums, or restricting coverage. GAOs analysis found that about 33.2 million adults age 19-64 years old, or about 18 percent, reported hypertension in 2009. Individuals with hypertension reported average annual expenditures related...
Medicare: Important Steps Have Been Taken, but More Could Be Done to Deter Fraud
GAO-12-671T: Published: Apr 24, 2012. Publicly Released: Apr 24, 2012.
The Centers for Medicare & Medicaid Services (CMS)the agency that administers Medicarehas made progress in implementing several key strategies GAO identified in prior work as helpful in protecting Medicare from fraud; however, some actions that could help combat fraud remain incomplete.Provider Enrollment: GAOs previous work found persistent weaknesses in Medicares enrollme...
National Preparedness: Countermeasures for Thermal Burns
GAO-12-304R: Published: Feb 22, 2012. Publicly Released: Feb 22, 2012.
The SNS contains supportive care items for thermal burns, such as bandages, pain medications, intravenous fluids, and topical antimicrobial cream needed for the immediate treatment of burn injuries to reduce the risk of infection and stabilize injured individuals. HHS officials told us that the goal of the SNS is to supplement state and local supplies used for immediate care in the initial respons...