Health care services (71 - 80 of 1,006 items)
Health Care Access: Improved Oversight, Accountability, and Prioritization Can Improve Access for Native American Veterans
GAO-14-489: Published: Jun 10, 2014. Publicly Released: Jun 10, 2014.
The Department of Veterans Affairs (VA) and the Indian Health Service (IHS) have taken a variety of actions to improve access to care for Native American veterans under their 2010 memorandum of understanding (MOU); however according to stakeholders, these agencies face substantial implementation challenges. VA and IHS have taken actions to (1) strengthen outreach and enrollment through information...
VA Health Care: Ongoing and Past Work Identified Access, Oversight, and Data Problems That Hinder Veterans' Ability to Obtain Timely Outpatient Medical Care
GAO-14-679T: Published: Jun 9, 2014. Publicly Released: Jun 9, 2014.
GAO's ongoing work examining the Department of Veterans Affairs' (VA) Veterans Health Administration's (VHA) process for managing outpatient specialty care consults has identified examples of delays in veterans receiving outpatient specialty care. GAO has found consults—requests for evaluation or management of a patient for a specific clinical concern—that were not processed in accordance with...
VA Real Property: Action Needed to Improve the Leasing of Outpatient Clinics
GAO-14-300: Published: Apr 30, 2014. Publicly Released: Jun 3, 2014.
Schedules were delayed and costs increased for the majority of the Department of Veterans Affairs' (VA) leased outpatient projects reviewed. As of January 2014, GAO found that 39 of the 41 projects reviewed—with a contract value of about $2.5 billion—experienced schedule delays, ranging from 6 months to 13.3 years, with an average delay of 3.3 years. The large majority of delays occurred prior...
Medicare: Further Action Could Improve Improper Payment Prevention and Recoupment Efforts
GAO-14-619T: Published: May 20, 2014. Publicly Released: May 20, 2014.
The Centers for Medicare & Medicaid Services (CMS), the agency within the Department of Health and Human Services (HHS) that oversees Medicare, has made progress improving improper payment prevention and recoupment efforts in the Medicare fee-for-service (FFS) program, but further actions are needed.Provider enrollment. CMS has implemented certain provider enrollment screening procedures authorize...
VA Health Care: VA Lacks Accurate Information about Outpatient Medical Appointment Wait Times, Including Specialty Care Consults
GAO-14-620T: Published: May 15, 2014. Publicly Released: May 15, 2014.
As GAO previously reported in its testimony on April 9, 2014, its preliminary work examining the Department of Veterans Affairs' (VA), Veterans Health Administration's (VHA) management of outpatient specialty care consults identified examples of delays in veterans receiving outpatient specialty care, as well as limitations in the implementation of new consult business rules designed to standardize...
Department of Health and Human Services: Solicitations of Support for Enroll America
GAO-14-305R: Published: Mar 21, 2014. Publicly Released: Apr 21, 2014.
GAO’s review of written responses and documentation from the Department of Health and Human Services (HHS) found that, since enactment of the Patient Protection and Affordable Care Act (PPACA), the Secretary of HHS (the Secretary) contacted the Chief Executive Officers of five organizations to solicit support for one outside entity, Enroll America, involved in activities related to PPACA. Specif...
VA Health Care: Ongoing and Past Work Identified Access Problems That May Delay Needed Medical Care for Veterans
GAO-14-509T: Published: Apr 9, 2014. Publicly Released: Apr 9, 2014.
GAO's ongoing work examining VHA's management of outpatient specialty care consults identified examples of delays in veterans receiving outpatient specialty care, as well as limitations in the Department of Veterans Affairs' (VA), Veterans Health Administration's (VHA) implementation of new consult business rules designed to standardize aspects of the clinical consult process. For example, for 4 o...
Medicare: Nurse Anesthetists Billed for Few Chronic Pain Procedures; Implementation of CMS Payment Policy Inconsistent
GAO-14-153: Published: Feb 7, 2014. Publicly Released: Mar 10, 2014.
From 2009 through 2012, certified registered nurse anesthetists (CRNA)—a type of advanced-practice nurse specializing in anesthesia care—billed Medicare fee-for-service (FFS) for a minimal share of selected chronic pain procedures, less than ½ of 1 percent of these procedures in each year. Physicians without board certification in pain medicine billed for the majority of selected procedures e...
Defense Health Care: Acquisition Process for TRICARE's Third Generation of Managed Care Support Contracts
GAO-14-195: Published: Mar 7, 2014. Publicly Released: Mar 7, 2014.
The TRICARE Management Activity (TMA) within the Department of Defense (DOD) used the acquisition process prescribed by federal regulations to acquire health care services for the TRICARE Program through the third generation of TRICARE's managed care support contracts (MCSC). This process included a three-phased contract award process outlined in the figure below.TMA's Contract Award Process: Phas...
VA Health Care: Actions Needed to Improve Administration and Oversight of Veterans' Millennium Act Emergency Care Benefit
GAO-14-175: Published: Mar 6, 2014. Publicly Released: Mar 6, 2014.
The Veterans Millennium Health Care and Benefits Act (Millennium Act) authorizes the Department of Veterans Affairs (VA) to cover emergency care for conditions not related to veterans' service-connected disabilities when veterans who have no other health plan coverage receive care at non-VA providers. However, GAO identified a number of instances where VA staff who processed claims did not comply...