Health insurance (41 - 50 of 139 items)
Medicare Dialysis Facilities: Beneficiary Access Stable and Problems in Payment System Being Addressed
GAO-04-450: Published: Jun 25, 2004. Publicly Released: Jun 25, 2004.
Medicare covers about 90 percent of patients with end-stage renal disease (ESRD), the permanent loss of kidney function. Most ESRD patients receive regular hemodialysis treatments, a process that removes toxins from the blood, at a dialysis facility. A small percentage dialyzes-at home. From 1991 through 2001, the ESRD patient population more than doubled, from about 201,000 to 406,000. As the nee...
Medicare: Payment Changes Are Needed for Assistants-at-Surgery
GAO-04-97: Published: Jan 13, 2004. Publicly Released: Jan 13, 2004.
Medicare pays for assistant-atsurgery services under both the hospital inpatient prospective payment system and the physician fee schedule. Payments under the physician fee schedule are limited to a few health professions. In 2001, Congress directed GAO to report on the potential impact on the Medicare program of allowing physician fee schedule payments to Certified Registered Nurse First Assistan...
Private Health Insurance: Federal and State Requirements Affecting Coverage Offered by Small Business
GAO-03-1133: Published: Sep 30, 2003. Publicly Released: Oct 2, 2003.
Most employees in the U.S. have health coverage through employers. Small businesses with fewer than 50 employees, however, are less likely to offer coverage than larger businesses. Many say they cannot afford it. When they do provide coverage, small businesses typically purchase insurance policies, while larger businesses are more likely to use their own funds to pay for some of their employees' h...
Medicare Provider Enrollment: Opportunities to Enhance Program Integrity Efforts
GAO-03-185: Published: Mar 17, 2003. Publicly Released: Mar 17, 2003.
Staffing companies that contract with physicians to staff hospital departments--including emergency departments--are not permitted to bill Medicare. In the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, Congress directed GAO to assess the program integrity implications of enrolling these companies and allowing them to bill Medicare. GAO reviewed about 2.8 million em...
Medicare: Beneficiary Use of Clinical Preventive Services
GAO-02-422: Published: Apr 10, 2002. Publicly Released: May 23, 2002.
Preventive medicine, including immunizations for many diseases and screening for some types of cancer, holds the promise to extend and improve the quality of life for millions of Americans. Medicare now covers three preventive services for immunizations and three for screenings, and the Centers for Medicare and Medicaid Services (CMS) sponsors "interventions" to increase the use of preventive serv...
Medicare Subvention Demonstration: Pilot Satisfies Enrollees, Raises Cost and Management Issues for DOD Health Care
GAO-02-284: Published: Feb 11, 2002. Publicly Released: Feb 11, 2002.
The Department of Defense's (DOD) Medicare subvention demonstration tested alternate approaches to health care coverage for military retirees. Retirees could enroll in new DOD-run Medicare managed care plans, known as TRICARE Senior Prime, at six sites. The demonstration plan offered enrollees the full range of Medicare-covered services as well as additional TRICARE services, with minimal copaymen...
Medigap Insurance: Plans Are Widely Available but Have Limited Benefits and May Have High Costs
GAO-01-941: Published: Jul 31, 2001. Publicly Released: Jul 31, 2001.
To protect themselves against large out-of-pocket expenses and help fill gaps in Medicare coverage, most beneficiaries buy supplemental insurance, known as Medigap; contribute to employer-sponsored health benefits to supplement Medicare coverage; or enroll in private Medicare+Choice plans rather than traditional fee-for-service Medicare. Because Medicare+Choice plans are not available everywhere...
Health Care: Consultants' Billing Advice May Lead to Improperly Paid Insurance Claims
GAO-01-818: Published: Jun 27, 2001. Publicly Released: Jun 27, 2001.
This report investigates health care consultants who conduct seminars or workshops that offer advice to health care providers on ways to enhance revenue and avoid audits or investigations. GAO attended several seminars and workshops offered by these consultants. GAO sought to determine whether the consultants were providing advice that could result in improper or excessive claims to Medicare, Medi...
Health Care Fraud: Schemes to Defraud Medicare, Medicaid, and Private Health Care Insurers
T-OSI-00-15: Published: Jul 25, 2000. Publicly Released: Jul 25, 2000.
Pursuant to a congressional request, GAO discussed the various schemes used to defraud the Medicare and Medicaid programs and private insurance companies and how the proposed legislation contained in H.R. 3461 and S.1231 could strenghten federal and state health care programs.GAO noted that: (1) in the rent-a-patient scheme, organizations pay for--or "rent"--individuals to go to clinics for unnece...
Children With Disabilities: Medicaid Can Offer Important Benefits and Services
T-HEHS-00-152: Published: Jul 12, 2000. Publicly Released: Jul 12, 2000.
Pursuant to a congressional request, GAO discussed the feasibility of allowing some families with children with disabilities to purchase Medicaid coverage, focusing on: (1) what role Medicaid plays in providing health care coverage for children with disabilities; (2) the extent to which private insurance offers coverage of needed services for children with disabilities; and (3) the benefits and se...