Physicians (51 - 60 of 175 items)
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 Physician Payments: Medical Settings and Safety of Endoscopic Procedures
GAO-03-179: Published: Oct 18, 2002. Publicly Released: Oct 18, 2002.
Every year millions of Americans covered by Medicare undergo endoscopic medical procedures in a variety of health care settings ranging from physicians' offices to hospitals. These invasive procedures call for the use of a lighted, flexible instrument and are used for screening and treating disease. Although some of these procedures can be performed while the patient is fully awake, most require s...
Medicare: Using Education and Claims Scrutiny to Minimize Physician Billing Errors
GAO-02-778T: Published: May 28, 2002. Publicly Released: May 28, 2002.
In its audit for year 2001, the Department of Health and Human Services' Office of Inspector General found that $12.1 billion was improperly paid to Medicare providers. GAO's February report (GAO-02-249) showed that physicians often do not receive complete, accurate, clear, or timely guidance on Medicare billing and payment policies. At the carriers studied, GAO found significant shortcomings in p...
Defense Health Care: Across-the-Board Physician Rate Increases Would be Costly and Unnecessary
GAO-01-620: Published: May 24, 2001. Publicly Released: May 24, 2001.
This report describes the financial and management impact of increasing physician reimbursement rates in TRICARE -- the military's managed health care program. GAO found that changing the TRICARE reimbursement rate nationally to the 70th percentile of billed charges would be costly, inflationary, and largely unnecessary. Such an increase could cost the Defense Department (DOD) and its beneficiarie...
Medicare: Improper Third-Party Billing of Medicare by Behavioral Medical Systems, Inc.
OSI-00-5R: Published: Mar 30, 2000. Publicly Released: Apr 11, 2000.
Pursuant to a congressional request, GAO reviewed the operations of Behavioral Medical Systems, Inc.GAO noted that: (1) while BMS represented itself to the Medicare Program as a provider, in fact it functioned as a broker and a third-party biller; (2) GAO found a consistent pattern by which BMS caused improper Medicare claims to be submitted for services not provided by six psychiatrists; (3) of t...
Adverse Drug Events: The Magnitude of Health Risk Is Uncertain Because of Limited Incidence Data
HEHS-00-21: Published: Jan 18, 2000. Publicly Released: Feb 1, 2000.
Pursuant to a congressional request, GAO summarized from available research what is known about adverse drug events (ADE), focusing on the: (1) different types and causes of ADEs; (2) evidence on the overall incidence and cost of ADEs in the United States; and (3) measures that have been proposed to reduce the number and severity of ADEs.GAO noted that: (1) ADEs arise either from adverse drug reac...
Physician Performance: Report Cards Under Development but Challenges Remain
HEHS-99-178: Published: Sep 30, 1999. Publicly Released: Nov 1, 1999.
Pursuant to a congressional request, GAO reviewed efforts to provide the public with information on physician performance, focusing on: (1) the issues involved in measuring and reporting on physician and physician group performance; (2) efforts to develop physician report cards; and (3) initiatives under way that may address impediments to measuring physician and physician group performance.GAO no...
Veterans' Affairs: Potential Costs of Changes in Licensing Requirement Outweigh Benefit
HEHS-99-106: Published: May 21, 1999. Publicly Released: May 21, 1999.
Pursuant to a congressional request, GAO provided information on whether changing Department of Veterans Affairs (VA) health care personnel licensing requirements would effect VA's health care system, focusing on: (1) comparing VA's physician employment requirements and processes with those of other federal agencies; (2) comparing VA's requirements with those of private sector health care organiza...
Physician Shortage Areas: Medicare Incentive Payment Not an Effective Approach to Improve Access
HEHS-99-36: Published: Feb 26, 1999. Publicly Released: Feb 26, 1999.
Pursuant to a congressional request, GAO reviewed the Medicare Incentive Payment program to determine if: (1) it is an effective mechanism for improving access to care for Medicare beneficiaries and underserved populations other than Medicare beneficiaries; and (2) the program's goals, performance measures, and financial controls provide a sound structure for continuing or expanding the program.GA...
Specialty Care: Heart Attack Survivors Treated by Cardiologists More Likely to Take Recommended Drugs
HEHS-99-6: Published: Dec 4, 1998. Publicly Released: Jan 4, 1999.
Pursuant to a congressional request, GAO reviewed the potential differences in treatment patterns for health maintenance organizations (HMO) patients treated by specialists and those treated by generalist physicians, focusing on: (1) the proportion of Medicare heart attack survivors enrolled in HMOs who take cholesterol-lowering drugs, beta-blockers, and aspirin; and (2) whether Medicare heart att...