Medicaid (61 - 70 of 130 items)
Medicaid Managed Care: Serving the Disabled Challenges State Programs
HEHS-96-136: Published: Jul 31, 1996. Publicly Released: Jul 31, 1996.
Pursuant to a congressional request, GAO examined state efforts to include disabled Medicaid beneficiaries in prepaid managed care programs, focusing on the: (1) extent to which states are implementing Medicaid prepaid managed care programs for disabled beneficiaries; and (2) steps that have been taken to safeguard the interests of the stakeholder groups.GAO found that: (1) few states have signifi...
Medicaid Funding Formula Changes
HEHS-96-164R: Published: Jun 10, 1996. Publicly Released: Jun 10, 1996.
Pursuant to a congressional request, GAO provided information on the proposed changes to Medicaid funding formulas under H.R. 3507. GAO noted that: (1) states with large numbers of poor and disabled persons receive less federal assistance than states with larger numbers of poor and weaker tax bases; (2) states that offer extensive services and provide high provider reimbursement rates receive more...
Health Insurance: Coverage of Autologous Bone Marrow Transplantation for Breast Cancer
HEHS-96-83: Published: Apr 24, 1996. Publicly Released: May 28, 1996.
Pursuant to a congressional request, GAO reviewed insurance coverage of autologous bone marrow transplantation (ABMT) for breast cancer, focusing on: (1) the factors insurers consider when deciding whether to cover treatment; (2) the effectiveness of the treatment; and (3) the consequences of the increased use and insurance coverage of the treatment while it is still in clinical trials.GAO found t...
Health Systems Issue Area: Active Assignments
AA-96-15(2): Published: Apr 6, 1996. Publicly Released: Apr 6, 1996.
GAO provided information on its active assignments in its Health Systems issue area as of April 6, 1996...
State Medicaid Financing Practices
HEHS-96-76R: Published: Jan 23, 1996. Publicly Released: Jan 23, 1996.
Pursuant to a congressional request, GAO provided information on state Medicaid financing arrangements in Michigan, Tennessee, and Texas. GAO noted that: (1) until the Health Care Financing Administration (HCFA) ruled in 1985 that states could use Medicaid provider donations to reduce their share of Medicaid expenditures, states could only use provider donations for the cost of training administra...
Medicaid: Spending Pressures Spur States Toward Program Restructuring
T-HEHS-96-75: Published: Jan 18, 1996. Publicly Released: Jan 18, 1996.
GAO discussed how states are addressing rising Medicaid costs, focusing on the: (1) federal mandates that have led to Medicaid cost growth; (2) states' use of section 1115 waivers for managed care programs; and (3) states' experiences with section 1115 managed care programs. GAO noted that: (1) federal mandates, medical price inflation, and higher provider reimbursements have contributed to rising...
Health Financing and Public Health Issue Area: Active Assignments
AA-96-14(1): Published: Jan 2, 1996. Publicly Released: Jan 2, 1996.
GAO provided information on its active assignments in the Health Financing and Public Health issue area as of January 2, 1996...
Fraud and Abuse: Medicare Continues to Be Vulnerable to Exploitation by Unscrupulous Providers
T-HEHS-96-7: Published: Nov 2, 1995. Publicly Released: Nov 2, 1995.
GAO discussed challenges Medicare faces in battling fraud and abuse in the health care system, focusing on reasons that: (1) Medicare is an appealing target for unscrupulous providers; and (2) abusive practices persist despite efforts by program managers and law enforcement agencies. GAO noted that: (1) although most Medicare providers abide by program rules, Medicare has difficulty preventing fra...
Medicare Spending: Modern Management Strategies Needed to Curb Billions in Unnecessary Payments
HEHS-95-210: Published: Sep 19, 1995. Publicly Released: Sep 19, 1995.
Pursuant to a congressional request, GAO examined Medicare's vulnerability to provider exploitation and ways to remedy Medicare fraud and abuse.GAO found that Medicare is vulnerable to billions of dollars in unnecessary payments, since Medicare: (1) pays higher than market rates for certain services and supplies; (2) anti-fraud and abuse controls do not systematically prevent the payment of claims...
Health Financing and Public Health Issues Issue Area Plan--Fiscal Years 1996-98
IAP-95-34: Published: Aug 1, 1995. Publicly Released: Aug 1, 1995.
GAO presented its Health Financing and Public Health issue area plan for fiscal years 1996 through 1998.GAO plans to assess: (1) how the management and financial integrity of the Medicare and Medicaid programs can be improved; (2) new approaches to current payment methods that could curb Medicare spending growth; (3) how financing arrangements affect Medicare and Medicaid beneficiaries' access to...