Health care costs (121 - 130 of 541 items)
Medicare Outpatient Payments: Rates for Certain Radioactive Sources Used in Brachytherapy Could Be Set Prospectively
GAO-06-635: Published: Jul 24, 2006. Publicly Released: Jul 24, 2006.
Generally, in paying for hospital outpatient procedures, Medicare makes prospectively set payments that are intended to cover the costs of all items and services delivered with the procedure. Medicare pays separately for some technologies that are too new to be represented in the claims data used to set rates. It also pays separately for certain technologies that are not new, such as radioactive s...
Medicare Physician Services: Use of Services Increasing Nationwide and Relatively Few Beneficiaries Report Major Access Problems
GAO-06-704: Published: Jul 21, 2006. Publicly Released: Jul 21, 2006.
Congress, policy analysts, and groups representing physicians have periodically raised concerns that Medicare's efforts to control spending on physician services by limiting annual updates to physician fees could have an adverse impact on beneficiaries' access to physician services. These concerns were heightened in 2002 when Medicare's formula for setting physician fees required a 5.4 percent red...
Medicare Part B Drugs: CMS Data Source for Setting Payments Is Practical but Concerns Remain
GAO-06-971T: Published: Jul 13, 2006. Publicly Released: Jul 13, 2006.
In 2005, the Centers for Medicare & Medicaid Services (CMS), as required by law, began paying for physician-administered Part B drugs using information on the drugs' average sales price (ASP). Subsequently, CMS selected ASP as the basis to pay for a subset of Part B drugs provided at hospital outpatient departments. To calculate ASP, CMS uses price data submitted quarterly by manufacturers. GAO wa...
Consumer-Directed Health Plans: Small but Growing Enrollment Fueled by Rising Cost of Health Care Coverage
GAO-06-514: Published: Apr 28, 2006. Publicly Released: May 30, 2006.
Insurance carriers, employers, and individuals are showing increasing interest in consumer-directed health plans (CDHP). CDHPs typically combine a high-deductible health plan with a health reimbursement arrangement (HRA) or health savings account (HSA). HRAs and HSAs are tax-advantaged accounts used to pay enrollees' health care expenses, and unused balances may accrue for future use, potentially...
Ryan White CARE Act: AIDS Drug Assistance Programs, Perinatal HIV Transmission, and Partner Notification
GAO-06-681T: Published: Apr 26, 2006. Publicly Released: Apr 26, 2006.
Despite progress in HIV/AIDS drug treatments and the reduction of AIDS mortality in the United States, challenges remain concerning the availability of these drugs for individuals with HIV/AIDS and the prevention of new cases. The CARE Act authorizes grants to the states and certain territories specifically for AIDS Drug Assistance Programs (ADAP) to purchase and provide HIV/AIDS drugs to eligible...
Ryan White CARE Act: Improved Oversight Needed to Ensure AIDS Drug Assistance Programs Obtain Best Prices for Drugs
GAO-06-646: Published: Apr 26, 2006. Publicly Released: Apr 26, 2006.
The CARE Act authorized grants to the states and certain territories for AIDS Drug Assistance Programs (ADAP) to purchase and provide HIV/AIDS drugs to eligible individuals. An ADAP's coverage--who and what is covered--is determined by each ADAP's eligibility and other program criteria, and ADAPs may establish waiting lists for eligible individuals. ADAPs may purchase their drugs through the 340B...
Federal Employees Health Benefits Program: First-Year Experience with High-Deductible Health Plans and Health Savings Accounts
GAO-06-271: Published: Jan 31, 2006. Publicly Released: Feb 2, 2006.
The Federal Employees Health Benefits Program (FEHBP) recently began offering high-deductible health plans (HDHP) coupled with tax-advantaged health savings accounts (HSA) that enrollees use to pay for health care. Unused HSA balances may accumulate for future use, providing enrollees an incentive to purchase health care prudently. The plans also provide decision support tools to help enrollees ma...
VA Long-Term Care: Trends and Planning Challenges in Providing Nursing Home Care to Veterans
GAO-06-333T: Published: Jan 9, 2006. Publicly Released: Jan 9, 2006.
The Department of Veterans Affairs (VA) operates a nursing home program that provides or pays for veterans' care in three nursing home settings: VA-operated nursing homes, community nursing homes, and state veterans' nursing homes. In addition, veterans needing nursing home care may also receive it from non-VA providers that are not funded by VA. VA is faced with a large elderly veteran population...
Review of OMB Circular A-76 Health Benefit Cost Factor Needed
GAO-06-87R: Published: Nov 17, 2005. Publicly Released: Nov 17, 2005.
Determining whether to obtain required services using government employees or through contracts with the private sector is an important economic and strategic decision for agency managers. In this regard, Office of Management and Budget (OMB) Circular A-76 prescribes policies and procedures for use by agencies as they select service providers through competitions among public and private-sector so...
Medicare: Little Progress Made in Targeting Outpatient Therapy Payments to Beneficiaries' Needs
GAO-06-59: Published: Nov 10, 2005. Publicly Released: Nov 10, 2005.
For years, Congress has wrestled with rising Medicare costs and improper payments for outpatient therapy services--physical therapy, occupational therapy, and speech-language pathology. In 1997 Congress established per-person spending limits, or "therapy caps," for nonhospital outpatient therapy but, responding to concerns that some beneficiaries need extensive services, has since placed temporary...