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Health Care (161 - 170 of 4,934 items)
International Classification of Diseases: CMS Has Updated Systems and Supported Stakeholders' Efforts to Use New Codes
GAO-15-789: Published: Sep 17, 2015. Publicly Released: Sep 17, 2015.
The Centers for Medicare & Medicaid Services (CMS) has finished updating its systems with the changes it determined were needed to process the new International Classification of Diseases codes (ICD-10) on Medicare fee-for-service claims. In 2007, CMS began taking steps to identify components of its systems that needed to be changed to update the ICD codes from version 9 to 10. CMS began making th...
State Health Insurance Marketplaces: CMS Should Improve Oversight of State Information Technology Projects
GAO-15-527: Published: Sep 16, 2015. Publicly Released: Sep 16, 2015.
States reported to the Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS) that they spent about $1.45 billion in federal marketplace grant funding on information technology (IT) projects supporting health insurance marketplaces, as of March 2015. The majority of this spending was for state-based marketplaces (i.e., marketplaces established and operated by...
Electronic Cigarettes: Effect on Federal Excise Taxes Collected on Traditional Cigarettes Is Not Currently Evident
GAO-15-771: Published: Sep 14, 2015. Publicly Released: Sep 14, 2015.
GAO's analysis found no evidence that use of electronic cigarettes (e-cigarettes) has affected federal excise tax (FET) revenue from traditional cigarettes, which has been declining over time (see figure). Possible reasons for the lack of a detectable effect include the small size of the e-cigarette market (estimated at $2.5 billion in 2014) relative to the cigarette market ($80 billion in the sam...
Medicare Part D: Changes Needed to Improve CMS's Recovery Audit Program Operations and Contractor Oversight
GAO-15-633: Published: Aug 14, 2015. Publicly Released: Sep 14, 2015.
The Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) implemented the Part D recovery audit contractor (RAC) program in January 2011 by undertaking various activities, including establishing a statement of objectives and conducting a solicitation process to select a RAC to identify improper payments. However, CMS's challenges in setting expecta...
Defense Health Care Reform: Actions Needed to Help Ensure Defense Health Agency Maintains Implementation Progress
GAO-15-759: Published: Sep 10, 2015. Publicly Released: Sep 10, 2015.
Nearly 2 years after the creation of the Defense Health Agency (DHA), the Department of Defense (DOD) has made progress toward completing its implementation process, but has not addressed issues related to GAO's past recommendations regarding personnel requirements, an approach to cost savings, and performance measures.Personnel - The DHA has initiated the process of assessing personnel requiremen...
Private Health Insurance: The Range of Premiums and Plan Availability for Individuals in 2014 and 2015
GAO-15-687: Published: Aug 10, 2015. Publicly Released: Sep 9, 2015.
As of 2014, key provisions of the Patient Protection and Affordable Care Act (PPACA) resulted in the establishment of health insurance exchanges in each state and changed how insurers determined health insurance premiums. Individual market consumers generally had access to more health plans in 2015 compared to 2014, and in both years the lowest-cost plans were available through exchanges in most o...
Electronic Health Records: Outcome-Oriented Metrics and Goals Needed to Gauge DOD's and VA's Progress in Achieving Interoperability
GAO-15-530: Published: Aug 13, 2015. Publicly Released: Aug 13, 2015.
The Departments of Defense (DOD) and Veterans Affairs (VA), with guidance from the Interagency Program Office (IPO) that is tasked with facilitating the departments' efforts to share health information, have taken actions to increase interoperability between their electronic health record systems. Among other things, DOD and VA have initiated work focused on near-term objectives, including standar...
Medicaid: Additional Reporting May Help CMS Oversee Prescription-Drug Fraud Controls
GAO-15-390: Published: Jul 8, 2015. Publicly Released: Aug 10, 2015.
GAO found indicators of potential prescription-medication fraud and abuse among thousands of Medicaid beneficiaries and hundreds of prescribers during fiscal year 2011—the most-recent year for which reliable data were available in four selected states: Arizona, Florida, Michigan, and New Jersey. These states accounted for about 13 percent of all fiscal year 2011 Medicaid payments. Specifically,...
Federal Autism Research: Updated Information on Funding from Fiscal Years 2008 through 2012
GAO-15-583R: Published: Jun 30, 2015. Publicly Released: Jul 30, 2015.
Although federal funding for autism research fluctuated from fiscal years 2008 through 2012, it increased overall during this period, from approximately $169 million in fiscal year 2008 to $245 million in fiscal year 2012—about a 45 percent increase (about a 37 percent increase when adjusted for inflation to fiscal year 2012 dollars). Over this time period, the National Institutes of Health (NIH...
Medicaid: Key Issues Facing the Program
GAO-15-677: Published: Jul 30, 2015. Publicly Released: Jul 30, 2015.
GAO identified four key issues facing the Medicaid program, based on prior work.Access to care : Medicaid enrollees report access to care that is generally comparable to that of privately insured individuals and better than that of uninsured individuals, but may have greater health care needs and greater difficulty accessing specialty and dental care.Transparency and oversight : The lack of comple...