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Support Agencies, Legislative (1 - 10 of 21 items)
Mental Health and Substance Use: Treatment Exclusions in Employers' Health Insurance Coverage
GAO-12-761R: Published: May 31, 2012. Publicly Released: May 31, 2012.
In summary, this report provides information on the incidence of treatment exclusions for MH/SU for the 2011 or 2010 plan year and the 2008 plan year for employers that responded to our survey. In total, for the 2011 or 2010 plan year, of the 96 employers that responded to our question about whether their most popular plan excluded coverage for any specific treatments related to MH/SU, 39 employer...
Pre-Existing Condition Insurance Plan: Comparison of Implementation and Early Enrollment with the Children's Health Insurance Program
GAO-12-62R: Published: Nov 10, 2011. Publicly Released: Dec 13, 2011.
The federal Pre-Existing Condition Insurance Plan (PCIP) was created in 2010 to provide access to insurance for individuals previously unable to acquire coverage due to pre-existing conditions. Eligibility is limited to those who have been uninsured for at least 6 months prior to application, thus focusing the program on those who have been locked out of the private insurance market. The Patient P...
Nursing Homes: Private Investment Homes Sometimes Differed from Others in Deficiencies, Staffing, and Financial Performance
GAO-11-571: Published: Jul 15, 2011. Publicly Released: Aug 15, 2011.
Private investment (PI) firms' acquisition of several large nursing home chains led to concerns that the quality of care may have been adversely affected. These concerns may have been in part due to PI firms' business strategies and their lack of financial transparency compared to publicly traded companies. In September 2010, GAO reported on the extent of PI ownership of nursing homes and firms' i...
Head Start: Undercover Testing Finds Fraud and Abuse at Selected Head Start Centers
GAO-10-733T: Published: May 18, 2010. Publicly Released: May 18, 2010.
The Head Start program, overseen by the Department of Health and Human Services and administered by the Office of Head Start, provides child development services primarily to low-income families and their children. Federal law allows up to 10 percent of enrolled families to have incomes above 130 percent of the poverty line--GAO refers to them as "over-income." Families with incomes below 130 perc...
Hurricane Katrina: Federal Grants Have Helped Health Care Organizations Provide Primary Care, but Sustaining Services Will Be a Challenge
GAO-10-273T: Published: Dec 3, 2009. Publicly Released: Dec 3, 2009.
The greater New Orleans area--Jefferson, Orleans, Plaquemines, and St. Bernard parishes--continues to face challenges in restoring health care services disrupted by Hurricane Katrina which made landfall in August 2005. In 2007, the Department of Health and Human Services (HHS) awarded the $100 million Primary Care Access and Stabilization Grant (PCASG) to Louisiana to help restore primary care ser...
Federal Tort Claims Act: Information Related to Implications of Extending Coverage to Volunteers at HRSA-Funded Health Centers
GAO-09-693R: Published: Jun 24, 2009. Publicly Released: Jun 24, 2009.
The Federal Tort Claims Act (FTCA) was enacted in 1946 and permits individuals injured by the wrongful or negligent acts or omissions of federal employees, including medical malpractice, to seek and receive compensation from the federal government through an administrative process and, ultimately, through the federal courts. The FTCA, with few exceptions, provides the exclusive means by which indi...
Long-Term Care Insurance: Partnership Programs Include Benefits That Protect Policyholders and Are Unlikely to Result in Medicaid Savings
GAO-07-231: Published: May 11, 2007. Publicly Released: Jun 11, 2007.
Partnership programs allow individuals who purchase Partnership long-term care insurance policies to exempt at least some of their personal assets from Medicaid eligibility requirements. In response to a congressional request, GAO examined (1) the benefits and premium requirements of Partnership policies as compared with those of traditional long-term care insurance policies; (2) the demographics...
Medicare: CMS's Proposed Approach to Set Hospital Inpatient Payment Appears Promising
GAO-06-880: Published: Jul 28, 2006. Publicly Released: Jul 28, 2006.
Under Medicare's inpatient prospective payment system (IPPS), hospitals generally receive fixed payments for hospital stays based on diagnosis-related groups (DRG), a system that classifies stays by patient diagnosis and procedures. CMS is required to at least annually update DRG payments to address changes in the cost of inpatient care. CMS uses charge-based weights to update these payments. Cost...
Medicare Dialysis Facilities: Beneficiary Access Stable and Problems in Payment System Being Addressed
GAO-04-450: Published: Jun 25, 2004. Publicly Released: Jun 25, 2004.
Medicare covers about 90 percent of patients with end-stage renal disease (ESRD), the permanent loss of kidney function. Most ESRD patients receive regular hemodialysis treatments, a process that removes toxins from the blood, at a dialysis facility. A small percentage dialyzes-at home. From 1991 through 2001, the ESRD patient population more than doubled, from about 201,000 to 406,000. As the nee...
Medical Malpractice: Implications of Rising Premiums on Access to Health Care
GAO-03-836: Published: Aug 8, 2003. Publicly Released: Aug 29, 2003.
The recent rising cost of medical malpractice insurance premiums in many states has reportedly influenced some physicians to move or close practices, reduce high-risk services, or alter their practices to preclude potential lawsuits (known as defensive medicine practices). States have revised tort laws under which malpractice lawsuits are litigated to help constrain malpractice premium and claims...