Health insurance cost control (51 - 60 of 407 items)
Medicare: HCFA Could Do More to Identify and Collect Overpayments
HEHS/AIMD-00-304: Published: Sep 7, 2000. Publicly Released: Sep 7, 2000.
Pursuant to a congressional request, GAO provided information on efforts to recover Medicare's overpayments, focusing on: (1) how the Health Care Financing Administration (HCFA) and its contractors identify potential overpayments, and whether techniques used by recovery auditors would improve overpayment identification; (2) how well HCFA and its contractors collect overpayments once they are ident...
Medicare+Choice: Plan Withdrawals Indicate Difficulty of Providing Choice While Achieving Savings
HEHS-00-183: Published: Sep 7, 2000. Publicly Released: Sep 7, 2000.
Pursuant to a congressional request, GAO reviewed health care plans' withdrawal from the Medicare Choice program, focusing on the: (1) geographic distribution and the distribution among plans of enrollees affected by the recent plan withdrawals; (2) factors associated with plans that terminated or reduced their participation in the program; and (3) likely role of payment rates in affecting plans'...
Prescription Drugs: Expanding Access to Federal Prices Could Cause Other Price Changes
HEHS-00-118: Published: Aug 7, 2000. Publicly Released: Sep 6, 2000.
Pursuant to a congressional request, GAO provided information on the expansion of Medicare beneficiaries' access to prescription drugs, focusing on the: (1) federal drug price discounts available to federal and nonfederal purchasers and the size of those discounts; and (2) potential effects that extending such discounts to nonfederal purchasers may have on outpatient drug prices paid by federal an...
Medicare+Choice: Payments Exceed Cost of Fee-for-Service Benefits, Adding Billions to Spending
HEHS-00-161: Published: Aug 23, 2000. Publicly Released: Aug 23, 2000.
Pursuant to a congressional request, GAO reviewed Medicare Choice program payment issues, focusing on: (1) whether program spending for Medicare Choice plan enrollees has exceeded what Medicare-covered care for these beneficiaries would have cost in the fee-for-service (FFS) Medicare program; and (2) the extent to which payments to individual plans differ from expected FFS costs.GAO noted that: (1...
Medicare: Refinements Should Continue to Improve Appropriateness of Provider Payments
T-HEHS-00-160: Published: Jul 19, 2000. Publicly Released: Jul 19, 2000.
Pursuant to a congressional request, GAO discussed the effects of recent Medicare payment reforms, focusing on the Balanced Budget Act of 1997 (BBA) payment reforms affecting home health agencies, skilled nursing facilities (SNF), and the health plans in Medicare's managed care program, known as Medicare Choice.GAO noted that: (1) the reactions by providers serving Medicare beneficiaries to BBA an...
Medicaid: HCFA and States Could Work Together to Better Ensure the Integrity of Providers
T-HEHS-00-159: Published: Jul 18, 2000. Publicly Released: Jul 18, 2000.
Pursuant to a congressional request, GAO discussed the Health Care Financing Administration's (HCFA) efforts to better ensure the integrity of providers who bill the Medicaid program, focusing on: (1) why it is important to take steps to ensure that only honest providers bill federal health care programs; (2) what Medicare is doing to strengthen its provider enrollment process; (3) what states are...
Medicare Improper Payments: Challenges for Measuring Potential Fraud and Abuse Remain Despite Planned Enhancements
T-AIMD/OSI-00-251: Published: Jul 12, 2000. Publicly Released: Jul 12, 2000.
Pursuant to a congressional request, GAO discussed the Health Care Financing Administration's (HCFA) efforts to improve the measurement of improper payments in the Medicare fee-for-service program.GAO noted that: (1) because it was not intended to include procedures designed specifically to identify all types of potential fraudulent and abusive activity, the current methodology does not provide an...
Medicare Payments: Use of Revised 'Inherent Reasonableness' Process Generally Appropriate
HEHS-00-79: Published: Jul 5, 2000. Publicly Released: Jul 5, 2000.
Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) and the Durable Medical Equipment Regional Carriers' (DMERC) actions to implement a final rule for processing Medicare payments, focusing on whether: (1) it was proper for HCFA to issue its inherent reasonableness regulations as an interim final rule, and whether HCFA is authorized to delegate respo...
Mental Health Parity Act: Despite New Federal Standards, Mental Health Benefits Remain Limited
HEHS-00-95: Published: May 10, 2000. Publicly Released: May 18, 2000.
Pursuant to a congressional request, GAO reviewed the implementation of the Mental Health Parity Act of 1996, focusing on the: (1) extent to which employers comply with the law and how they have revised their health plans; (2) law's effect on claims costs; and (3) steps federal agencies have taken to ensure compliance with the law.GAO noted that: (1) 86 percent of the responding employers in the 2...
Mental Health Parity Act: Employers' Mental Health Benefits Remain Limited Despite New Federal Standards
T-HEHS-00-113: Published: May 18, 2000. Publicly Released: May 18, 2000.
GAO discussed the implementation and effects of the Mental Health Parity Act of 1996, focusing on: (1) employers' compliance with the law and the changes they have made to their health benefit plans, (2) what is known about the costs of complying with the law, and (3) the oversight roles of the Departments of Health and Human Services (HHS) and Labor (DOL) in enforcing this law.GAO noted that: (1)...