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Offices, Department of Health and Human Services, Executive (51 - 60 of 111 items)
Medicare Payment: CMS Methodology Adequate to Estimate National Error Rate
GAO-06-300: Published: Mar 24, 2006. Publicly Released: Mar 24, 2006.
The Centers for Medicare & Medicaid Services (CMS) estimated that the Medicare program paid approximately $20 billion (net) in error for fee-for-service (FFS) claims in fiscal year 2004. CMS established two programs--the Comprehensive Error Rate Testing (CERT) Program and the Hospital Payment Monitoring Program (HPMP)--to measure the accuracy of claims paid. The Medicare Prescription Drug, Improve...
Physician Services: Concierge Care Characteristics and Considerations for Medicare
GAO-05-929: Published: Aug 12, 2005. Publicly Released: Aug 12, 2005.
Concierge care is an approach to medical practice in which physicians charge their patients a membership fee in return for enhanced services or amenities. The recent emergence of concierge care has prompted federal concern about how the approach might affect beneficiaries of Medicare, the federal health insurance program for the aged and some disabled individuals. Concerns include the potential th...
Medicare: Advisory Opinions as a Means of Clarifying Program Requirements
GAO-05-129: Published: Dec 8, 2004. Publicly Released: Dec 8, 2004.
Health care providers are concerned about the quality of Medicare guidance issued by the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS). Specifically, they have reported that (1) they receive unclear guidance on program requirements and (2) because policies and procedures change frequently, they may rely on obsolete guidance, resu...
Child Care: State Efforts to Enforce Safety and Health Requirements
GAO-04-786: Published: Sep 9, 2004. Publicly Released: Oct 12, 2004.
The federal government requires states that receive funds from the Child Care and Development Fund to establish basic health and safety requirements. The federal government also requires states receiving federal funds for child care to have procedures in place to ensure that providers being paid with grant dollars comply with the applicable safety and health requirements. Because of the significan...
Welfare Reform: Rural TANF Programs Have Developed Many Strategies to Address Rural Challenges
GAO-04-921: Published: Sep 10, 2004. Publicly Released: Oct 12, 2004.
About 49 million people, or 17 percent of the country's total population, live in rural communities, and 18 states have at least a third of their population in rural areas. Rural areas often have less favorable employment conditions than urban areas and have fewer public transportation options to help people get to and from work. Given these conditions and the Temporary Assistance for Needy Famili...
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...
Supports For Low-Income Families: States Serve a Broad Range of Families through a Complex and Changing System
GAO-04-256: Published: Jan 26, 2004. Publicly Released: Jan 26, 2004.
Over the last decade, the Congress has made significant changes in numerous federal programs that support low-income families, including changes that have shifted program emphases from providing cash assistance to providing services that promote employment and economic independence. As a result of some of the federal policy changes, the support system is more decentralized than before. This height...
Medicare: Most Beneficiaries Receive Some but Not All Recommended Preventive Services
GAO-03-958: Published: Sep 8, 2003. Publicly Released: Oct 8, 2003.
Medicare, the federal health program insuring almost 35 million beneficiaries age 65 and older, covers certain preventive services, such as flu shots and mammograms. Most beneficiaries receive care through Medicare's fee-for-service program, under which they generally receive these services as part of visits to the doctor for specific illnesses or conditions. Other beneficiaries receive services u...
Newborn Screening: Characteristics of State Programs
GAO-03-449: Published: Mar 17, 2003. Publicly Released: Apr 16, 2003.
Each year state newborn screening programs test 4 million newborns for disorders that require early detection and treatment to prevent serious illness or death. GAO was asked to provide the Congress with information on the variations among state newborn screening programs, including information on criteria considered in selecting disorders to include in state programs, education for parents and pr...
Medicaid and SCHIP: States Use Varying Approaches to Monitor Children's Access to Care
GAO-03-222: Published: Jan 14, 2003. Publicly Released: Feb 14, 2003.
Over 25 million children have health insurance coverage through Medicaid or the State Children's Health Insurance Program (SCHIP). Coverage alone, however, does not guarantee that services will be available or that children will receive needed care. GAO was asked to evaluate states' efforts to facilitate and monitor access to primary and preventive services for children in these jointly funded fed...