Hospitals (21 - 30 of 82 items)
Medicare Fraud and Abuse: DOJ Continues to Promote Compliance with False Claims Act Guidance
GAO-02-546: Published: Apr 5, 2002. Publicly Released: Apr 5, 2002.
The Department of Justice (DOJ) recovered more than $1.2 billion in health care fraud cases in fiscal year 2001. The False Claims Act bolstered DOJ's recoveries and enabled the government to seek damages and penalties against providers who knowingly submitted fraudulent bills to Medicare, Medicaid, or other government programs. In the late 1990s, industry representatives voiced concerns that DOJ...
Ambulance Services: Changes Needed to Improve Medicare Payment Policies and Coverage Decisions
GAO-02-244T: Published: Nov 15, 2001. Publicly Released: Nov 15, 2001.
The Balanced Budget Act of 1997 required Medicare to change its payment system for ambulance services. In response, the Health Care Financing Administration (HCFA), now called the Centers for Medicare and Medicaid Services (CMS), proposed a fee schedule to standardize payments across provider types on the basis of national rates for particular services. Under the act, the fee schedule was to have...
VA Health Care: VA Has Not Sufficiently Explored Alternatives for Optimizing Third-Party Collections
GAO-01-1157T: Published: Sep 20, 2001. Publicly Released: Sep 20, 2001.
The Department of Veterans Affairs (VA) has reversed the general decline in its third-party collections for the first time since fiscal year 1995. The fiscal year 2001 increase appears to be largely the result of VA's implementation of a new system, known as the reasonable charges billing system, which allowed VA to move from a flat-rate billing system to one that itemizes charges. However, long-s...
Medicare and Managed Care Plans: Payments and Costs for Selected Hospitals
HEHS-00-177R: Published: Sep 1, 2000. Publicly Released: Sep 1, 2000.
Pursuant to a congressional request, GAO reviewed Medicare and managed care plan hospital costs and payments, focusing on: (1) the relationship between Medicare and managed care plan payments and costs; (2) managed care plan payments and the relative importance of managed care business; and (3) Medicare and managed care plan payments and costs by hospital teaching status.GAO noted that: (1) for th...
Health Care Financing Administration: Medicare Program--Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for 2000
OGC-00-13: Published: Dec 13, 1999. Publicly Released: Dec 13, 1999.
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on inpatient hospital deductible and hospital extended care services coinsurance amounts for 2000. GAO noted that: (1) the rule would announce the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 2000 und...
HCFA: Medicare Program: Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 1999 Rates
OGC-98-70: Published: Aug 14, 1998. Publicly Released: Aug 14, 1998.
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on changes to the hospital inpatient prospective payment systems and fiscal year 1999 rates. GAO noted that: (1) the final rule would revise the Medicare hospital inpatient prospective payment systems for operating costs and capital-related costs to implement applicable statutory requirem...
VA Health Care: Closing a Chicago Hospital Would Save Millions and Enhance Access to Services
HEHS-98-64: Published: Apr 16, 1998. Publicly Released: Apr 16, 1998.
Pursuant to a congressional request, GAO reviewed whether the Veterans Health Administration (VHA) could serve veterans in Chicago, Illinois, with three hospitals, focusing on: (1) the extent of the resources that could be redirected to improve patient care; and (2) the potential impact of one hospital closure on VHA's other missions.GAO noted that: (1) VHA can meet the health care needs of Chicag...
Medicaid: Disproportionate Share Payments to State Psychiatric Hospitals
HEHS-98-52: Published: Jan 23, 1998. Publicly Released: Jan 23, 1998.
Pursuant to a congressional request, GAO reviewed Medicaid disproportionate share hospital (DSH) program payments to state psychiatric institutions, focusing on: (1) how the amount of DSH payments to state psychiatric hospitals compares with DSH payments made to other types of hospitals; (2) how the proportion of Medicaid beneficiaries in state psychiatric hospitals compares with the proportion in...
Medicaid: Disproportionate Share Hospital Payments to Institutions for Mental Diseases
HEHS-97-181R: Published: Jul 15, 1997. Publicly Released: Jul 15, 1997.
GAO provided information on disproportionate share hospital (DSH) programs that provide funds to institutions for mental diseases in selected states.GAO noted that: (1) its work to date indicates that the 1993-1995 growth in mental health DSH payments pre dates full implementation of the hospital-specific caps mandated by the Omnibus Budget Reconciliation Act (OBRA) of 1993; (2) in 1996, both tota...
HCFA: Medicare Program--Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 1997 Rates
OGC-96-41: Published: Sep 13, 1996. Publicly Released: Sep 13, 1996.
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on changes to the Medicare Program's hospital inpatient prospective payment systems and fiscal year 1997 rates. GAO found that: (1) the rule would adjust the classifications and weighting factors for diagnosis related groups, update the wage index associated with hospital operating costs,...