Medical services rates (11 - 20 of 111 items)
Medicare: Past Experience Can Guide Future Competitive Bidding for Medical Equipment and Supplies
GAO-04-765: Published: Sep 7, 2004. Publicly Released: Sep 7, 2004.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) requires the Centers for Medicare & Medicaid Services (CMS) to conduct large-scale competitive bidding for durable medical equipment, supplies, off-the-shelf orthotics, and enteral nutrients and related equipment and supplies provided to beneficiaries. The Balanced Budget Act of 1997 mandated that GAO study an earlier...
Medicare Hospital and Physician Payments: Geographic Cost Adjustments Important to Preserve Beneficiary Access to Services
GAO-02-968T: Published: Jul 23, 2002. Publicly Released: Jul 23, 2002.
This testimony discusses Medicare program payment adjustments to hospitals and physicians that account for geographic differences in costs. Because Medicare's hospital and physician payment systems are based on national rates, these geographic cost adjustments are essential to account for costs beyond providers' control and to ensure that beneficiaries have adequate access to services. If these ad...
Medicare Physician Payments: Spending Targets Encourage Fiscal Discipline, Modifications Could Stabilize Fees
GAO-02-441T: Published: Feb 14, 2002. Publicly Released: Feb 14, 2002.
Congress implemented a physician fee schedule and a fee update formula to moderate spending growth relative to specified Medicare spending targets. These spending targets increase annually to reflect higher costs for physician services, the growth in the overall economy, and changes in the number of Medicare beneficiaries. Physician fees are adjusted for changes in the costs of providing services...
Skilled Nursing Facilities: Services Excluded From Medicare's Daily Rate Need to be Reevaluated
GAO-01-816: Published: Aug 22, 2001. Publicly Released: Aug 22, 2001.
Congress and the Health Care Financing Administration recognized that certain services needed to be excluded from the skilled nursing facility (SNF) prospective payment system (PPS) rate to help ensure beneficiary access to appropriate care and to financially protect the SNFs that take care of high-cost patients. The criteria used to identify services--high cost, infrequently provided during a SNF...
Defense Health Care: Across-the-Board Physician Rate Increases Would be Costly and Unnecessary
GAO-01-620: Published: May 24, 2001. Publicly Released: May 24, 2001.
This report describes the financial and management impact of increasing physician reimbursement rates in TRICARE -- the military's managed health care program. GAO found that changing the TRICARE reimbursement rate nationally to the 70th percentile of billed charges would be costly, inflationary, and largely unnecessary. Such an increase could cost the Defense Department (DOD) and its beneficiarie...
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 Home Health Care: Prospective Payment System Could Reverse Recent Declines in Spending
HEHS-00-176: Published: Sep 8, 2000. Publicly Released: Sep 8, 2000.
Pursuant to a congressional request, GAO provided information on Medicare home health care's recent declines in spending, focusing on: (1) the declines in service use underlying the changes in spending; (2) the extent of the changes in use across beneficiaries, home health agencies (HHA), and locations; and (3) identify any implications these new patterns of home health use have for the impact of...
Nursing Homes: Aggregate Medicare Payments Are Adequate Despite Bankruptcies
T-HEHS-00-192: Published: Sep 5, 2000. Publicly Released: Sep 5, 2000.
Pursuant to a congressional request, GAO discussed the causes of the bankruptcies of large corporations owning nursing homes and the implications for nursing home residents, focusing on: (1) the adequacy of Medicare's payment rates for skilled nursing services furnished in nursing homes; (2) the relationship between the changes wrought by the Balanced Budget Act and recent nursing home bankruptcie...
Medicare: Access to Home Oxygen Largely Unchanged; Closer HCFA Monitoring Needed
HEHS-99-56: Published: Apr 5, 1999. Publicly Released: Apr 5, 1999.
Pursuant to a legislative requirement, GAO provided information on Medicare beneficiaries' access to home oxygen equipment, focusing on: (1) changes in access to home oxygen for Medicare patients since the payment reduction mandated by the Balanced Budget Act (BBA) of 1997 took effect; and (2) actions taken by the Health Care Financing Administration (HCFA) to fulfill the BBA requirements and resp...
Medicare: Interim Payment System for Home Health Agencies
T-HEHS-98-234: Published: Aug 6, 1998. Publicly Released: Aug 6, 1998.
GAO discussed: (1) the rise in Medicare spending for home health services and the reasons for this growth; (2) the objectives of the home health interim payment system enacted by the Balanced Budget Act of 1997; and (3) concerns about the level and distribution of home health payments.GAO noted that: (1) a well-designed prospective payment system will provide the Medicare program with the best mea...