Medicare (81 - 90 of 486 items)
Nursing Homes: Opportunities Exist to Facilitate the Use of the Temporary Management Sanction
GAO-10-37R: Published: Nov 20, 2009. Publicly Released: Dec 22, 2009.
The nation's 1.4 million nursing home residents are a highly vulnerable population of elderly and disabled individuals for whom remaining at home is no longer feasible. The federal government plays a key role in ensuring that nursing home residents receive appropriate care by setting quality requirements that nursing homes must meet to participate in the Medicare and Medicaid programs and by contr...
Hurricane Katrina: Federal Grants Have Helped Health Care Organizations Provide Primary Care, but Sustaining Services Will Be a Challenge
GAO-10-273T: Published: Dec 3, 2009. Publicly Released: Dec 3, 2009.
The greater New Orleans area--Jefferson, Orleans, Plaquemines, and St. Bernard parishes--continues to face challenges in restoring health care services disrupted by Hurricane Katrina which made landfall in August 2005. In 2007, the Department of Health and Human Services (HHS) awarded the $100 million Primary Care Access and Stabilization Grant (PCASG) to Louisiana to help restore primary care ser...
Indian Health Service: Updated Policies and Procedures and Increased Oversight Needed for Billings and Collections from Private Insurers
GAO-10-42R: Published: Oct 22, 2009. Publicly Released: Nov 23, 2009.
The Indian Health Service (IHS), an agency in the Department of Health and Human Services (HHS), provides health care services to American Indians and Alaskan Natives. For fiscal year 2009, Congress appropriated approximately $3.6 billion for health care services to be made available through IHS. The agency provides direct medical care, including primary care services, ancillary services, and some...
Improper Payments: Responses to Posthearing Questions Related to Eliminating Waste and Fraud in Medicare and Medicaid
GAO-09-838R: Published: Jul 20, 2009. Publicly Released: Jul 20, 2009.
On April 22, 2009, GAO testified before the subcommittee at a hearing entitled, "Eliminating Waste and Fraud in Medicare and Medicaid." This letter responds to a May 29, 2009, request for responses to questions for the record related to our April 22, 2009, testimony. The questions are as follows: (1) What do you see as the biggest challenge for CMS to provide an estimate for improper payments unde...
Prescription Drugs: Overview of Approaches to Control Prescription Drug Spending in Federal Programs
GAO-09-819T: Published: Jun 24, 2009. Publicly Released: Jun 24, 2009.
Millions of individuals receive prescription drugs through federal programs. The increasing cost of prescription drugs has put pressure to control drug spending on federal programs such as the Federal Employees Health Benefits Program (FEHBP), Medicare Part D, the Department of Veterans Affairs (VA), the Department of Defense (DOD), and Medicaid. Prescription drug spending within the FEHBP in part...
Hospital Emergency Departments: Crowding Continues to Occur, and Some Patients Wait Longer than Recommended Time Frames
GAO-09-347: Published: Apr 30, 2009. Publicly Released: Jun 1, 2009.
Hospital emergency departments are a major part of the nation's health care safety net. Of the estimated 119 million visits to U.S. emergency departments in 2006, over 40 percent were paid for by federally-supported programs. These programs--Medicare, Medicaid, and the State Children's Health Insurance Program--are administered by the Department of Health and Human Services (HHS). There have been...
End-Stage Renal Disease: CMS Should Monitor Effect of Bundled Payment on Home Dialysis Utilization Rates
GAO-09-537: Published: May 22, 2009. Publicly Released: May 22, 2009.
Medicare covers dialysis--a process that removes excess fluids and toxins from the bloodstream--for most individuals with end-stage renal disease (ESRD), a condition of permanent kidney failure. Most patients with ESRD receive dialysis in a facility, while some patients with ESRD are trained to self-perform dialysis in their homes. The Centers for Medicare & Medicaid Services (CMS)--the agency tha...
Medicare and Medicaid Participating Facilities: CMS Needs to Reexamine Its Approach for Funding State Oversight of Health Care Facilities
GAO-09-64: Published: Feb 13, 2009. Publicly Released: Mar 19, 2009.
Americans receive care from tens of thousands of health care facilities participating in Medicare and Medicaid. To ensure the quality of care, CMS contracts with states to conduct periodic surveys and complaint investigations. Federal spending on such activities totaled about $444 million in fiscal year 2007; states are expected to contribute their own funds both through the Medicaid program and a...
Nonprofit Hospitals: Variation in Standards and Guidance Limits Comparison of How Hospitals Meet Community Benefit Requirements
GAO-08-880: Published: Sep 12, 2008. Publicly Released: Oct 14, 2008.
Nonprofit hospitals qualify for federal tax exemption from the Internal Revenue Service (IRS) if they meet certain requirements. Since 1969, IRS has not specified that these hospitals have to provide charity care to meet these requirements, so long as they engage in activities that benefit the community. Many of these activities are intended to benefit the approximately 47 million uninsured indivi...
Medicaid Financing: Long-standing Concerns about Inappropriate State Arrangements Support Need for Improved Federal Oversight
GAO-08-650T: Published: Apr 3, 2008. Publicly Released: Apr 3, 2008.
Medicaid, a joint federal-state program, financed the health care for about 59 million low-income people in fiscal year 2006. States have considerable flexibility in deciding what medical services and individuals to cover and the amount to pay providers, and the federal government reimburses a portion of states' expenditures according to a formula established by law. The Centers for Medicare & Med...