Commerce (1 - 10 of 59 items)
NIH Chimpanzee Management Program: Consolidation Should Achieve Cost Savings, but a Clear Implementation Plan Is Needed
GAO-16-392: Published: Apr 14, 2016. Publicly Released: Apr 14, 2016.
NIH-owned and NIH-supported chimpanzees are no longer used in invasive biomedical research, which is research that involves medical treatment outside of normal veterinary care. However, all NIH-owned and NIH-supported chimpanzees are eligible for use in non-invasive research, such as observational and behavioral research, even at the federal chimpanzee retirement sanctuary, Chimp Haven. Most of th...
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...
Healthcare.gov: CMS Has Taken Steps to Address Problems, but Needs to Further Implement Systems Development Best Practices
GAO-15-238: Published: Mar 4, 2015. Publicly Released: Mar 4, 2015.
Several problems with the initial development and deployment of Healthcare.gov and its supporting systems led to consumers encountering widespread performance issues when trying to create accounts and enroll in health plans:Inadequate capacity planning: The Centers for Medicare & Medicaid Services (CMS) did not plan for adequate capacity to support Healthcare.gov and its supporting systems.Softwar...
Private Health Insurance: The Range of Average Annual Premiums in the Small Group Market by State in Early 2013
GAO-14-524R: Published: May 28, 2014. Publicly Released: Jun 24, 2014.
GAO reported the range of average premiums for health insurance products sold to small employers in the small group market of each of the 50 states and the District of Columbia during the first quarter of 2013. The average premiums reflected information from data submitted by insurers to the Center for Consumer Information and Insurance Oversight (CCIIO) within the Department of Health and Human S...
Department of Health and Human Services: Solicitations of Support for Enroll America
GAO-14-305R: Published: Mar 21, 2014. Publicly Released: Apr 21, 2014.
GAO’s review of written responses and documentation from the Department of Health and Human Services (HHS) found that, since enactment of the Patient Protection and Affordable Care Act (PPACA), the Secretary of HHS (the Secretary) contacted the Chief Executive Officers of five organizations to solicit support for one outside entity, Enroll America, involved in activities related to PPACA. Specif...
Tobacco Products: FDA Spending and New Product Review Time Frames
GAO-14-508T: Published: Apr 8, 2014. Publicly Released: Apr 8, 2014.
The Food and Drug Administration (FDA) spent (obligated) less than half of the $1.1 billion in tobacco user fees it collected from manufacturers and others from fiscal year 2009 through the end of fiscal year 2012; however, FDA's spending increased substantially in fiscal year 2013. Through December 31, 2013, FDA spent nearly 81 percent of the approximately $1.75 billion in fees collected by that...
Medicaid: Use of Claims Data for Analysis of Provider Payment Rates
GAO-14-56R: Published: Jan 6, 2014. Publicly Released: Jan 6, 2014.
Among the 9 states and 35 services examined, GAO found that all states varied Medicaid payments for at least some services. However, the states differed in the number of services for which they varied payments, in the factors that accounted for variation, and in the magnitude of the variation. Many of the states varied payment rates by at least one of the factors GAO was able to explore in detail:...
Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011-2012
GAO-14-21R: Published: Oct 24, 2013. Publicly Released: Oct 24, 2013.
Hospitals and health care professionals, such as physicians, were awarded a total of approximately $6.3 billion in Medicare electronic health records (EHR) incentive payments for 2012, which is more than twice the $2.3 billion awarded to hospitals and professionals for 2011. Almost half of eligible hospitals and less than a third of eligible professionals received Medicare EHR incentive payments f...
Medicare Program Integrity: Increasing Consistency of Contractor Requirements May Improve Administrative Efficiency
GAO-13-522: Published: Jul 23, 2013. Publicly Released: Aug 22, 2013.
The Centers for Medicare & Medicaid Services' (CMS) contractors that conduct postpayment reviews on Medicare fee-for-service (FFS) claims were established by different legislative actions; are managed by different offices within CMS; and serve different functions in the program. These contractors include (1) Medicare Administrative Contractors that process and pay claims and are responsible for ta...
Medicare Outpatient Therapy: Implementation of the 2012 Manual Medical Review Process
GAO-13-613: Published: Jul 10, 2013. Publicly Released: Jul 10, 2013.
The Centers for Medicare & Medicaid Services (CMS) implemented two types of manual medical reviews (MMR)--reviews of preapproval requests and reviews of claims submitted without preapproval--for all outpatient therapy services that were above a $3,700 per-beneficiary threshold provided during the last 3 months of 2012. However, CMS did not issue complete guidance on how to process preapproval requ...