Health care programs (31 - 40 of 1,056 items)
Veterans' Health Care: Preliminary Observations on VHA's Claims Processing Delays and Efforts to Improve the Timeliness of Payments to Community Providers
GAO-16-380T: Published: Feb 11, 2016. Publicly Released: Feb 11, 2016.
To help ensure that veterans are provided timely and accessible health care services, the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) has purchased care from non-VA community providers through its care in the community programs since as early as 1945. GAO's preliminary work from the sites it visited shows that in fiscal year 2015, VHA's claims processing was sig...
Medicare and Medicaid: Additional Oversight Needed of CMS's Demonstration to Coordinate the Care of Dual-Eligible Beneficiaries
GAO-16-31: Published: Dec 18, 2015. Publicly Released: Jan 19, 2016.
Due to the flexibility that states have in designing their Financial Alignment Demonstrations, the integrated care organizations that GAO interviewed in California, Illinois, Massachusetts, Virginia, and Washington implemented care coordination for dual-eligible Medicare and Medicaid beneficiaries in a variety of ways. For example, these organizations assigned care coordinators to beneficiaries us...
Health Care Workforce: Comprehensive Planning by HHS Needed to Meet National Needs
GAO-16-17: Published: Dec 11, 2015. Publicly Released: Jan 11, 2016.
The Department of Health and Human Services (HHS) engages in some planning for the 72 health care workforce programs administered by its agencies, but lacks comprehensive planning and oversight to ensure that these efforts meet national health care workforce needs. HHS's current strategic plan includes broad strategies—such as improving access to comprehensive primary and preventive medical serv...
DOD and VA Health Care: Actions Needed to Help Ensure Appropriate Medication Continuation and Prescribing Practices
GAO-16-158: Published: Jan 5, 2016. Publicly Released: Jan 5, 2016.
The Department of Defense (DOD) and the Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) have collaborated to develop clinical practice guidelines for post-traumatic stress disorder (PTSD) and mild traumatic brain injury (TBI). The mild TBI guideline does not include recommendations based on scientific evidence regarding the use of medications to treat symptoms because of...
Medicaid Financing: Questionnaire Data on States' Methods for Financing Medicaid Payments from 2008 through 2012 (GAO-15-227SP, March 2015), an E-supplement to GAO-14-627 [Reissued on December 7, 2015]
GAO-15-227SP: Published: Mar 13, 2015. Publicly Released: Mar 13, 2015.
This e-publication supplements our report, GAO-14-627, by presenting comprehensive results of a GAO web-based questionnaire on state methods for financing Medicaid payments, which was fielded to all 50 states and the District of Columbia between July 2013 and November 2013.The questionnaire collected information on states' use of seven different sources of funds to finance the nonfederal share of...
Workers' Compensation: Health Benefit Programs for Returned Peace Corps Volunteers and for Employees of U.S. Agency for International Development Contractors
GAO-16-28R: Published: Oct 30, 2015. Publicly Released: Oct 30, 2015.
Peace Corps and the U.S. Agency for International Development (USAID) both provide health benefits through workers' compensation programs. Peace Corps provides benefits to returned Peace Corps volunteers who sustain illnesses or injuries connected to their Peace Corps service under the Federal Employees' Compensation Act (FECA) program administered by the Department of Labor (DOL). USAID provides...
VA Mental Health: Action Needed to Improve Access Policies and Wait-Time Data
GAO-16-170T: Published: Oct 28, 2015. Publicly Released: Oct 28, 2015.
The way in which the Department of Veterans Affairs’ (VA) Veterans Health Administration (VHA) calculates veteran mental health wait times may not always reflect the overall amount of time a veteran waits for care. VHA uses a veteran’s preferred date (determined when an appointment is scheduled) to calculate the wait time for that patient’s full mental health evaluation, the primary entry po...
Medicaid: Additional Efforts Needed to Ensure that State Spending is Appropriately Matched with Federal Funds
GAO-16-53: Published: Oct 16, 2015. Publicly Released: Oct 23, 2015.
PPACA-expansion and state-expansion enrollees—individuals who were not eligible under historic Medicaid eligibility rules but are eligible under (1) a state option to expand Medicaid under the Patient Protection and Affordable Care Act (PPACA), or (2) a state's qualifying expansion of coverage prior to PPACA's enactment—comprised about 14 percent of Medicaid enrollees and about 10 percent of M...
Medicaid and Insurance Exchanges: Additional Federal Controls Needed to Minimize Potential for Gaps and Duplication in Coverage
GAO-16-73: Published: Oct 9, 2015. Publicly Released: Oct 23, 2015.
CMS's policies and procedures do not sufficiently minimize the potential for coverage gaps and duplicate coverage in federal exchange states. GAO found that individuals transitioning from Medicaid to exchange coverage—that is, private health insurance purchased through the exchanges created under the Patient Protection and Affordable Care Act (PPACA)—may experience coverage gaps, for example,...
Patient Protection and Affordable Care Act: Preliminary Results of Undercover Testing of the Federal Marketplace and Selected State Marketplaces for Coverage Year 2015
GAO-16-159T: Published: Oct 23, 2015. Publicly Released: Oct 22, 2015.
Under the Patient Protection and Affordable Care Act (PPACA), health-insurance marketplaces are required to verify application information to determine eligibility for enrollment and, if applicable, determine eligibility for income-based subsidies or Medicaid. These verification steps include reviewing and validating information about an applicant's Social Security number, if one is provided; citi...