Program management (71 - 80 of 126 items)
Medicare Integrity Program: Agency Approach for Allocating Funds Should Be Revised
GAO-06-813: Published: Sep 6, 2006. Publicly Released: Oct 6, 2006.
Since 1990, GAO has considered Medicare at high risk for fraud, waste, abuse, and mismanagement. The Medicare Integrity Program (MIP) provides funds to the Centers for Medicare & Medicaid Services (CMS--the agency that administers Medicare--to safeguard over $300 billion in program payments made on behalf of its beneficiaries. CMS conducts five program integrity activities: audits; medical reviews...
Medicaid Integrity: Implementation of New Program Provides Opportunities for Federal Leadership to Combat Fraud and Abuse
GAO-06-578T: Published: Mar 28, 2006. Publicly Released: Mar 28, 2006.
Today's hearing concerns fraud, waste, and abuse control in Medicaid, a program that provides health care coverage for over 56 million eligible low-income people and is jointly financed by the federal government and the states. In fiscal year 2004, Medicaid had benefit payments of $287 billion, with a federal share of about $168 billion. The states are primarily responsible for ensuring appropriat...
September 11: Monitoring of World Trade Center Health Effects Has Progressed, but Program for Federal Responders Lags Behind
GAO-06-481T: Published: Feb 28, 2006. Publicly Released: Feb 28, 2006.
After the 2001 attack on the World Trade Center (WTC), nearly 3,000 people died and an estimated 250,000 to 400,000 people in the vicinity were affected. An estimated 40,000 people who responded to the disaster--including New York City Fire Department (FDNY) personnel and other government and private-sector workers and volunteers--were exposed to physical and mental health hazards. Concerns remain...
Health Centers: Competition for Grants and Efforts to Measure Performance Have Increased
GAO-05-645: Published: Jul 13, 2005. Publicly Released: Aug 12, 2005.
Health centers in the federal Consolidated Health Centers program provide comprehensive primary health care services at one or more delivery sites, without regard to patients' ability to pay. In fiscal year 2002, the Health Resources and Services Administration (HRSA) began implementing the 5-year President's Health Centers Initiative. The initiative's goal is for the program to provide 1,200 gran...
Administrative Expenditures and Federal Matching Rates of Selected Support Programs
GAO-05-839R: Published: Jun 30, 2005. Publicly Released: Jul 28, 2005.
The federal government spends billions of dollars annually for programs that help low-income families and other individuals. A significant portion of these funds cover administrative costs rather than direct benefits and services. To provide information on how these administrative costs compare across programs and the federal government's role in funding these programs' administrative costs, we ex...
Defense Health Care: Implementation Issues for New TRICARE Contracts and Regional Structure
GAO-05-773: Published: Jul 27, 2005. Publicly Released: Jul 27, 2005.
The Department of Defense (DOD) provides health care through TRICARE--a regionally structured program that uses civilian contractors to maintain provider networks to complement health care provided at military treatment facilities (MTF). In 2004, DOD implemented extensive changes to its TRICARE contracts and regional structure. A committee report accompanying the Ronald W. Reagan National Defense...
Medicaid Fraud and Abuse: CMS's Commitment to Helping States Safeguard Program Dollars Is Limited
GAO-05-855T: Published: Jun 28, 2005. Publicly Released: Jun 28, 2005.
Today's hearing addresses fraud and abuse control in Medicaid, a program that provides health care coverage for eligible low-income individuals and is jointly financed by the federal government and the states. In fiscal year 2003, Medicaid covered nearly 54 million people and the program's benefit payments totaled roughly $261 billion, of which the federal share was about $153 billion. States are...
Medicaid: States' Efforts to Maximize Federal Reimbursements Highlight Need for Improved Federal Oversight
GAO-05-836T: Published: Jun 28, 2005. Publicly Released: Jun 28, 2005.
Medicaid--the federal-state health care financing program covering almost 54 million low-income people at a cost of $276 billion in fiscal year 2003--is by its size and structure at significant risk of waste and exploitation. Because of challenges inherent in overseeing the program, which is administered federally by the Centers for Medicare & Medicaid Services (CMS), GAO added Medicaid to its lis...
Medicaid Financing: States' Use of Contingency-Fee Consultants to Maximize Federal Reimbursements Highlights Need for Improved Federal Oversight
GAO-05-748: Published: Jun 28, 2005. Publicly Released: Jun 28, 2005.
Medicaid--the federal-state health care financing program covering nearly 54 million low-income people at a cost of $276 billion in fiscal year 2003--is by its size and structure at risk of waste and exploitation. Because of challenges inherent in overseeing the program, administered federally by the Centers for Medicare & Medicaid Services (CMS), GAO in 2003 added Medicaid to its list of high-ris...
Medicaid Managed Care: Access and Quality Requirements Specific to Low-Income and Other Special Needs Enrollees
GAO-05-44R: Published: Dec 8, 2004. Publicly Released: Dec 8, 2004.
The use of managed care within Medicaid, a joint federal-state program that finances health insurance for certain low-income families with children and individuals who are aged or disabled, increased significantly during the 1990s. By 2003, 59 percent of Medicaid beneficiaries were enrolled in managed care, compared with less than 10 percent in 1991. Medicaid managed care, under which states make...