Health care cost control (31 - 40 of 648 items)
Medicare Advantage Organizations: Actual Expenses and Profits Compared to Projections for 2006
GAO-09-132R: Published: Dec 8, 2008. Publicly Released: Dec 11, 2008.
The federal government's spending on the Medicare Advantage (MA) program has grown substantially in recent years, from approximately $60 billion in 2006 and $77 billion in 2007 to an estimated $91 billion in 2008. MA organizations provide health care coverage to Medicare beneficiaries through private health plans, thus offering an alternative to the original Medicare fee-for-service (FFS) program...
State and Local Fiscal Challenges: Rising Health Care Costs Drive Long-term and Immediate Pressures
GAO-09-210T: Published: Nov 19, 2008. Publicly Released: Nov 19, 2008.
GAO was asked to provide its views on projected trends in health care costs and their effect on the long-term outlook for state and local governments in the context of the current economic environment. This statement addresses three key points: (1) the state and local government sector's long-term fiscal challenges; (2) rapidly rising health care costs which drive the sector's long-term fiscal dif...
Highlights of a Forum: Ensuring Opportunities for Disadvantaged Children and Families
GAO-09-18SP: Published: Nov 13, 2008. Publicly Released: Nov 13, 2008.
Investments in the education and health of children are critical to the nation's future, as the nation's security and well-being depend on a productive citizenry. While families play the essential role in nurturing their children, the federal government has traditionally provided aid to disadvantaged children and families. However, federal spending on current health care and retirement programs--M...
Medicare Part D Prescription Drug Coverage: Federal Oversight of Reported Price Concessions Data
GAO-08-1074R: Published: Sep 30, 2008. Publicly Released: Oct 30, 2008.
To help Medicare beneficiaries manage the rising cost of prescription drugs, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), which established the outpatient prescription drug benefit known as Medicare Part D. The benefit was first available in January 2006, and that year it provided federally subsidized prescription drug coverage for nearly 28 mil...
Nonprofit Hospitals: Variation in Standards and Guidance Limits Comparison of How Hospitals Meet Community Benefit Requirements
GAO-08-880: Published: Sep 12, 2008. Publicly Released: Oct 14, 2008.
Nonprofit hospitals qualify for federal tax exemption from the Internal Revenue Service (IRS) if they meet certain requirements. Since 1969, IRS has not specified that these hospitals have to provide charity care to meet these requirements, so long as they engage in activities that benefit the community. Many of these activities are intended to benefit the approximately 47 million uninsured indivi...
Medicare: Trends in Fees, Utilization, and Expenditures for Imaging Services before and after Implementation of the Deficit Reduction Act of 2005
GAO-08-1102R: Published: Sep 26, 2008. Publicly Released: Sep 26, 2008.
Rapid spending growth for Medicare Part B--which covers physician and other outpatient services--has heightened concerns about the long-range fiscal sustainability of Medicare. Medicare Part B expenditures are expected to increase over the next decade at an average annual rate of about 8 percent, which is faster than the projected 4.8 percent annual growth rate in the national economy over this ti...
Medicare: Covert Testing Exposes Weaknesses in the Durable Medical Equipment Supplier Screening Process
GAO-08-955: Published: Jul 3, 2008. Publicly Released: Aug 4, 2008.
According to the Department of Health and Human Services (HHS), schemes to defraud the Medicare program have grown more elaborate in recent years. In particular, HHS has acknowledged Centers for Medicare & Medicaid Service's (CMS) oversight of suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) is inadequate to prevent fraud and abuse. Specifically, weaknesses in...
Hurricane Katrina: Trends in the Operating Results of Five Hospitals in New Orleans before and after Hurricane Katrina
GAO-08-681R: Published: Jul 17, 2008. Publicly Released: Jul 17, 2008.
New Orleans faces many challenges in the aftermath of Hurricane Katrina including the challenge of reestablishing the health care system and hospitals within the system. Hurricane Katrina, which made landfall on August 29, 2005, and the subsequent flooding caused by the failure of the New Orleans levee systems, resulted in the sudden closure, damage, or disruption in services at many of the New Or...
Medicare Part B Imaging Services: Rapid Spending Growth and Shift to Physician Offices Indicate Need for CMS to Consider Additional Management Practices
GAO-08-452: Published: Jun 13, 2008. Publicly Released: Jul 14, 2008.
The Centers for Medicare & Medicaid Services (CMS)--an agency within the Department of Health and Human Services (HHS)--and the Congress, through the Deficit Reduction Act of 2005 (DRA), recently acted to constrain spending on imaging services, one of the fastest growing set of services under Medicare Part B, which covers physician and other outpatient services. GAO was asked to provide informatio...
VA Health Care: Ineffective Controls over Medical Center Billings and Collections Limit Revenue from Third-Party Insurance Companies
GAO-08-675: Published: Jun 10, 2008. Publicly Released: Jul 10, 2008.
GAO previously reported that continuing problems in billing and collection processes at the Department of Veterans Affairs (VA) impaired VA's ability to maximize revenue from private (third-party) insurance companies. VA has undertaken several initiatives to address these weaknesses. GAO was asked to perform a follow-up audit to (1) evaluate VA billing controls, (2) assess VA-wide controls for col...