Medicaid (21 - 30 of 270 items)
Children's Health Insurance: Information on Coverage of Services, Costs to Consumers, and Access to Care in CHIP and Other Sources of Insurance
GAO-14-40: Published: Nov 21, 2013. Publicly Released: Dec 20, 2013.
In five selected states, GAO determined that the separate State Children's Health Insurance Program (CHIP) plans were generally comparable to the benchmark plans selected by states in 2012 as models for the benefits that will be offered through qualified health plans (QHP) in 2014. The plans were comparable in the services they covered and the services on which they imposed limits, although there...
Medicare Supplemental Coverage: Medigap and Other Factors Are Associated with Higher Estimated Health Care Expenditures
GAO-13-811: Published: Sep 19, 2013. Publicly Released: Oct 21, 2013.
GAO's analysis of the Centers for Medicare & Medicaid Services' 2010 Medicare Current Beneficiary Survey (MCBS) showed that estimated average total health care expenditures were higher for beneficiaries with Medigap or employer-sponsored coverage than for beneficiaries with traditional fee-for-service (FFS) Medicare only. While estimated average expenditures were lower for beneficiaries with Medic...
Medicaid Managed Care: Use of Limited Benefit Plans to Provide Mental Health Services and Efforts to Coordinate Care
GAO-13-780: Published: Sep 30, 2013. Publicly Released: Sep 30, 2013.
Thirteen states reported that in fiscal year 2012 they paid a total of about $5.6 billion to limited benefit plans to provide mental health services to about 4.4 million adult Medicaid beneficiaries. States can enroll different populations--such as adults who are blind, disabled, or have developmental disabilities--in limited benefit plans, which could contribute to the variation in the number of...
Dental Services: Information on Coverage, Payments, and Fee Variation
GAO-13-754: Published: Sep 6, 2013. Publicly Released: Sep 12, 2013.
Overall, trends in dental coverage show little change from 1996 to 2010--around 62 percent of individuals had coverage. The percentage of the population with private dental coverage decreased from 53 to 50 percent. Dental coverage through Medicaid or the State Children's Health Insurance Program (CHIP), which was established in 1997, rose from 9 to 13 percent. The increase was due primarily to an...
Indian Health Service: Most American Indians and Alaska Natives Potentially Eligible for Expanded Health Coverage, but Action Needed to Increase Enrollment
GAO-13-553: Published: Sep 5, 2013. Publicly Released: Sep 5, 2013.
GAO estimates, on the basis of recent U.S. Census Bureau data, that most American Indians and Alaska Natives will be potentially eligible for either expanded or new coverage options created by the Patient Protection and Affordable Care Act (PPACA). These options include expanded eligibility for Medicaid--the federal-state program for certain low-income individuals--and eligibility for the Health I...
Medicare: Legislative Modifications Have Resulted in Payment Adjustments for Most Hospitals
GAO-13-334: Published: Apr 17, 2013. Publicly Released: May 16, 2013.
Over time, Congress has modified how Medicare reimburses certain hospitals under the inpatient prospective payment system (IPPS), which pays hospitals a flat fee per stay, set in advance, with different amounts for each type of condition. GAO identified numerous statutory provisions that individually increased Medicare payments to a subset of hospitals.Seven provisions enabled hospitals to be paid...
Medicaid: Alternative Measures Could Be Used to Allocate Funding More Equitably
GAO-13-434: Published: May 10, 2013. Publicly Released: May 10, 2013.
GAO identified multiple data sources that could be used to develop measures to allocate Medicaid funding to states more equitably than the current funding formula--known as the Federal Medical Assistance Percentage (FMAP)--which is based solely on per capita income (PCI). To be equitable from the perspective of beneficiaries and allow states to provide a comparable level of services to each person...
Medicaid: States Made Multiple Program Changes, and Beneficiaries Generally Reported Access Comparable to Private Insurance
GAO-13-55: Published: Nov 15, 2012. Publicly Released: Nov 15, 2012.
From 2008 to 2011, more than half of states reported maintaining or decreasing their average Medicaid application processing times--the average number of calendar days between the receipt of a new application and the final determination of eligibility. The average processing times reported by 39 states ranged from 11 to 45 calendar days. For the same time period, however, GAO was unable to assess...
Medicaid: States' Use of Managed Care
GAO-12-872R: Published: Aug 17, 2012. Publicly Released: Sep 17, 2012.
In summary, we identified four groups of states that differed in their use of Medicaid managed care on the basis of the 12 indicators we included in our analysis. A handful of these indicatorsnamely Medicaid enrollment in MCOs and PCCM programs, HMO penetration rates, and the concentration of low-income individuals that lived in urban areashad significant influence on how states groupe...
Foster Children: HHS Guidance Could Help States Improve Oversight of Psychotropic Prescriptions
GAO-12-270T: Published: Dec 1, 2011. Publicly Released: Dec 1, 2011.
Foster children have often been removed from abusive or neglectful homes and tend to have more mental health conditions than other children. Treatment may include psychotropic drugs but their risks to children are not well understood. Medicaid, administered by states and overseen by the Department of Health and Human Services (HHS), provides prescription drug coverage to foster children. This test...