Health insurance cost control (21 - 30 of 122 items)
Prescription Drugs: Drug Company Programs Help Some People Who Lack Coverage
GAO-01-137: Published: Nov 16, 2000. Publicly Released: Nov 16, 2000.
As Congress considers Medicare beneficiaries' access to prescription drug coverage, there is increased interest in the range of options available to help vulnerable populations obtain access to needed medications. Patient assistance programs, offered voluntarily by drug companies, are generally designed to provide prescription drugs to low-income persons who lack drug coverage. These programs typi...
Medicare and Medicaid: Implementing State Demonstrations for Dual Eligibles Has Proven Challenging
HEHS-00-94: Published: Aug 18, 2000. Publicly Released: Sep 18, 2000.
Pursuant to a congressional request, GAO reviewed states' initiatives to enroll dual eligibles (beneficiaries who qualify for both Medicare and Medicaid benefits) into one managed care plan, focusing on: (1) the status and key features of state initiatives focusing on: (1) the status and key features of state initiatives to integrate care for dual-eligible beneficiaries; and (2) factors that have...
Long-Term Care Insurance: Better Information Critical to Prospective Purchasers
T-HEHS-00-196: Published: Sep 13, 2000. Publicly Released: Sep 13, 2000.
Pursuant to a congressional request, GAO discussed the challenges the baby boom generation and society face in planning for and financing its future long-term care needs, and the role that private long-term care insurance may play in meeting those challenges, focusing on: (1) the increased demand the baby boom generation will likely create for long-term care; (2) an overview of current spending fo...
Medicare+Choice: Plan Withdrawals Indicate Difficulty of Providing Choice While Achieving Savings
HEHS-00-183: Published: Sep 7, 2000. Publicly Released: Sep 7, 2000.
Pursuant to a congressional request, GAO reviewed health care plans' withdrawal from the Medicare Choice program, focusing on the: (1) geographic distribution and the distribution among plans of enrollees affected by the recent plan withdrawals; (2) factors associated with plans that terminated or reduced their participation in the program; and (3) likely role of payment rates in affecting plans'...
Prescription Drugs: Expanding Access to Federal Prices Could Cause Other Price Changes
HEHS-00-118: Published: Aug 7, 2000. Publicly Released: Sep 6, 2000.
Pursuant to a congressional request, GAO provided information on the expansion of Medicare beneficiaries' access to prescription drugs, focusing on the: (1) federal drug price discounts available to federal and nonfederal purchasers and the size of those discounts; and (2) potential effects that extending such discounts to nonfederal purchasers may have on outpatient drug prices paid by federal an...
Medicare+Choice: Payments Exceed Cost of Fee-for-Service Benefits, Adding Billions to Spending
HEHS-00-161: Published: Aug 23, 2000. Publicly Released: Aug 23, 2000.
Pursuant to a congressional request, GAO reviewed Medicare Choice program payment issues, focusing on: (1) whether program spending for Medicare Choice plan enrollees has exceeded what Medicare-covered care for these beneficiaries would have cost in the fee-for-service (FFS) Medicare program; and (2) the extent to which payments to individual plans differ from expected FFS costs.GAO noted that: (1...
Medicare: Refinements Should Continue to Improve Appropriateness of Provider Payments
T-HEHS-00-160: Published: Jul 19, 2000. Publicly Released: Jul 19, 2000.
Pursuant to a congressional request, GAO discussed the effects of recent Medicare payment reforms, focusing on the Balanced Budget Act of 1997 (BBA) payment reforms affecting home health agencies, skilled nursing facilities (SNF), and the health plans in Medicare's managed care program, known as Medicare Choice.GAO noted that: (1) the reactions by providers serving Medicare beneficiaries to BBA an...
Medicaid: HCFA and States Could Work Together to Better Ensure the Integrity of Providers
T-HEHS-00-159: Published: Jul 18, 2000. Publicly Released: Jul 18, 2000.
Pursuant to a congressional request, GAO discussed the Health Care Financing Administration's (HCFA) efforts to better ensure the integrity of providers who bill the Medicaid program, focusing on: (1) why it is important to take steps to ensure that only honest providers bill federal health care programs; (2) what Medicare is doing to strengthen its provider enrollment process; (3) what states are...
Medicare Payments: Use of Revised 'Inherent Reasonableness' Process Generally Appropriate
HEHS-00-79: Published: Jul 5, 2000. Publicly Released: Jul 5, 2000.
Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) and the Durable Medical Equipment Regional Carriers' (DMERC) actions to implement a final rule for processing Medicare payments, focusing on whether: (1) it was proper for HCFA to issue its inherent reasonableness regulations as an interim final rule, and whether HCFA is authorized to delegate respo...
Prescription Drugs: Adapting Private Sector Management Methods for a Medicare Benefit
T-HEHS-00-112: Published: May 11, 2000. Publicly Released: May 11, 2000.
Pursuant to a congressional request, GAO discussed the President's proposal to manage the high and rising costs of prescription drugs for the elderly by extending the private sector's prescription drug cost control techniques to the Medicare program.GAO noted that: (1) private insurers, managed care plans, and employers have tried to manage the high and rising costs of prescription drugs by adopti...