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Offices, Department of Health and Human Services, Executive (61 - 70 of 110 items)
Skilled Nursing Facilities: Providers Have Responded to Medicare Payment System By Changing Practices
GAO-02-841: Published: Aug 23, 2002. Publicly Released: Aug 23, 2002.
In 1998, the Health Care Financing Administration implemented a prospective payment system (PPS) for skilled nursing facility (SNF) services provided to Medicare beneficiaries. PPS is intended to control the growth in Medicare spending for skilled nursing and rehabilitative services that SNFs provide. Two years after the implementation of PPS, the mix of patients across the categories of payment g...
Welfare Reform: With TANF Flexibility, States Vary in How They Implement Work Requirements and Time Limits
GAO-02-770: Published: Jul 5, 2002. Publicly Released: Jul 5, 2002.
Congress created the Temporary Assistance for Needy Families (TANF) block grant to replace the previous welfare program and help welfare recipients transition into employment. To this end, states are required to enforce work requirements, and face financial penalties if a minimum percentage of adults receiving cash assistance do not participate in work or work-related activities each year. This fe...
Medicare: Orthotics Ruling Has Implications for Beneficiary Access and Federal and State Costs
GAO-02-330: Published: May 22, 2002. Publicly Released: May 22, 2002.
In the late 1980s and early 1990s, the Health Care Financing Administration (HCFA), now called the Centers for Medicare and Medicaid Services (CMS), became concerned that some suppliers were improperly billing Medicare for items that attach to wheelchairs and other equipment. Some suppliers were billing for such items using codes for orthodic devices, including arm, back, and neck braces that prov...
Health Care: Consultants' Billing Advice May Lead to Improperly Paid Insurance Claims
GAO-01-818: Published: Jun 27, 2001. Publicly Released: Jun 27, 2001.
This report investigates health care consultants who conduct seminars or workshops that offer advice to health care providers on ways to enhance revenue and avoid audits or investigations. GAO attended several seminars and workshops offered by these consultants. GAO sought to determine whether the consultants were providing advice that could result in improper or excessive claims to Medicare, Medi...
Nursing Homes: Sustained Efforts Are Essential to Realize Potential of the Quality Initiatives
HEHS-00-197: Published: Sep 28, 2000. Publicly Released: Sep 28, 2000.
Pursuant to a congressional request, GAO provided information on federal and state initiatives to improve the quality of nursing homes, focusing on: (1) progress in improving the detection of quality problems and changes in measured nursing home quality; (2) the status of efforts to strengthen states' complaint investigation processes and federal enforcement policies; and (3) additional steps take...
Medicare: More Beneficiaries Use Hospice but for Fewer Days of Care
HEHS-00-182: Published: Sep 18, 2000. Publicly Released: Sep 18, 2000.
Pursuant to a congressional request, GAO provided information on the Medicare hospice benefit, focusing on: (1) the patterns and trends in hospice use by Medicare beneficiaries; (2) factors that affect the use of the hospice benefit; and (3) the availability of hospice providers to serve the needs of Medicare beneficiaries.GAO noted that: (1) the number of Medicare beneficiaries choosing hospice s...
Medicare+Choice: Plan Withdrawals Indicate Difficulty of Providing Choice While Achieving Savings
HEHS-00-183: Published: Sep 7, 2000. Publicly Released: Sep 7, 2000.
Pursuant to a congressional request, GAO reviewed health care plans' withdrawal from the Medicare Choice program, focusing on the: (1) geographic distribution and the distribution among plans of enrollees affected by the recent plan withdrawals; (2) factors associated with plans that terminated or reduced their participation in the program; and (3) likely role of payment rates in affecting plans'...
Department of Health and Human Services, Office of the Secretary: Health Insurance Reform: Standards for Electronic Transactions
OGC-00-59: Published: Aug 29, 2000. Publicly Released: Aug 29, 2000.
Pursuant to a legislative requirement, GAO reviewed the Department of Health and Human Services' (HHS) new rule on, standards for electronic transactions. GAO noted that: (1) the new rule would adopt standards for eight electronic transactions and for codes sets used in those transactions and requires the use of these standards by health plans, health care clearinghouses, and certain health care p...
Medicare: Health Care Fraud and Abuse Control Program Financial Reports for Fiscal Years 1998 and 1999
AIMD-00-257R: Published: Jul 31, 2000. Publicly Released: Jul 31, 2000.
Pursuant to a legislative requirement, GAO reviewed the Health Care Fraud and Abuse Control (HCFAC) Program financial reports for fiscal years (FY) 1998 and 1999 as required by the the Health Insurance Portability and Accountability Act (HIPAA) of 1996.GAO noted that: (1) the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) joint HCFAC reports for fiscal years 1998...
Medicare Improper Payments: Challenges for Measuring Potential Fraud and Abuse Remain Despite Planned Enhancements
T-AIMD/OSI-00-251: Published: Jul 12, 2000. Publicly Released: Jul 12, 2000.
Pursuant to a congressional request, GAO discussed the Health Care Financing Administration's (HCFA) efforts to improve the measurement of improper payments in the Medicare fee-for-service program.GAO noted that: (1) because it was not intended to include procedures designed specifically to identify all types of potential fraudulent and abusive activity, the current methodology does not provide an...