Medicaid (41 - 50 of 167 items)
Medicaid Formula: Differences in Funding Ability among States Often Are Widened
GAO-03-620: Published: Jul 10, 2003. Publicly Released: Aug 11, 2003.
A primary goal in establishing Medicaid's statutory formula, whereby states with lower per capita incomes (PCI) receive higher rates of federal reimbursement for program costs, was to narrow differences among states in their ability to fund Medicaid services. States' ability to fund services depends on their financial resources in relation to their number of and costs to serve people in poverty. G...
Long-Term Care: Federal Oversight of Growing Medicaid Home and Community-Based Waivers Should Be Strengthened
GAO-03-576: Published: Jun 20, 2003. Publicly Released: Jul 7, 2003.
Home and community-based settings have become a growing part of states' Medicaid long-term care programs, serving as an alternative to care in institutional settings, such as nursing homes. To cover such services, however, states often obtain waivers from certain federal statutory requirements. GAO was asked to review (1) trends in states' use of Medicaid home and community-based service (HCBS) wa...
Highlights of a GAO Symposium: Addressing Key Challenges in an Intergovernmental Setting
GAO-03-365SP: Published: Mar 31, 2003. Publicly Released: Mar 31, 2003.
Responding to many of the nation's critical challenges--such as meeting the health care needs of the poor or countering terrorist threats--has been the joint responsibility of all levels of government. The effectiveness of federal programs has increasingly become dependent on state and local management and resources, as well as constructive interactions between federal, state, and local actors, in...
Medicaid and SCHIP: Recent HHS Approvals of Demonstration Waiver Projects Raise Concerns
GAO-02-817: Published: Jul 12, 2002. Publicly Released: Aug 7, 2002.
States provide health care coverage to about 40 million uninsured, low-income adults and children under two federal-state programs--Medicaid and the State Children's Health Insurance Program (SCHIP). To receive federal funding, states must meet statutory requirements, including providing certain levels of benefits to specified populations. Under section 1115 of the Social Security Act, the Secreta...
Nursing Homes: Quality of Care More Related to Staffing than Spending
GAO-02-431R: Published: Jun 13, 2002. Publicly Released: Jul 15, 2002.
Costs for nursing home care have almost doubled since 1990, from $53 billion to $92 billion in 2000. Much of that spending has been financed with public monies. Under the Medicare and Medicaid programs, the federal government financed 39 percent of the nation's nursing home spending in 2000, up from 28 percent in 1990. As federal outlays have grown, Congress has focused attention on the quality of...
Medicare: Recent CMS Reforms Address Carrier Scrutiny of Physicians' Claims for Payment
GAO-02-693: Published: May 28, 2002. Publicly Released: May 28, 2002.
In 1990, GAO designated the Medicare program to be at high-risk for waste, fraud, and abuse. More than a decade later, Medicare remains on GAO's high-risk list. This report examines Medicare's claims review process, which is designed to detect improper billing or payments. GAO found that most physicians who bill Medicare are largely unaffected by carriers' medical reviews, with 90 percent of physi...
Medicare: Orthotics Ruling Has Implications for Beneficiary Access and Federal and State Costs
GAO-02-330: Published: May 22, 2002. Publicly Released: May 22, 2002.
In the late 1980s and early 1990s, the Health Care Financing Administration (HCFA), now called the Centers for Medicare and Medicaid Services (CMS), became concerned that some suppliers were improperly billing Medicare for items that attach to wheelchairs and other equipment. Some suppliers were billing for such items using codes for orthodic devices, including arm, back, and neck braces that prov...
Health Centers and Rural Clinics: Payments Likely to Be Constrained Under Medicaid's New System
GAO-01-577: Published: Jun 19, 2001. Publicly Released: Jun 21, 2001.
To increase the accessibility of primary and preventive health services for low-income people living in medically underserved areas, Congress made federally qualified health centers and rural health clinics eligible for Medicaid payments. Since 1989, federal law has required Medicaid to reimburse both the centers and the clinics on the basis of reasonable costs they incurred in providing services...
Medicare: Higher Expected Spending and Call for New Benefit Underscore Need for Meaningful Reform
GAO-01-539T: Published: Mar 22, 2001. Publicly Released: Mar 22, 2001.
Much is at stake when it comes to Medicare reform--not only the program's future but also the nation's fiscal flexibility to pursue other important national goals and programs in the future. A comprehensive effort to reform Medicare and put it on a sustainable path would help fulfill this generation's stewardship responsibility to succeeding generations. It would also help to preserve some capacit...
Prescription Drugs: Increasing Medicare Beneficiary Access and Related Implications
T-HEHS/AIMD-00-100: Published: Feb 16, 2000. Publicly Released: Feb 16, 2000.
Pursuant to a congressional request, GAO discussed options for increasing Medicare beneficiaries' access to prescription drugs, focusing on the: (1) factors contributing to the growth in prescription drug spending and efforts to control that growth; and (2) design and implementation issues to be considered regarding proposals to improve seniors' access to affordable prescription drugs.GAO noted th...