Medicare (41 - 50 of 486 items)
Health Care Fraud and Abuse Control Program: Indicators Provide Information on Program Accomplishments, but Assessing Program Effectiveness is Difficult
GAO-13-746: Published: Sep 30, 2013. Publicly Released: Oct 30, 2013.
In fiscal year 2012, the Department of Health and Human Services (HHS), HHS Office of Inspector General (HHS-OIG), and the Department of Justice (DOJ) obligated approximately $583.6 million to fund Health Care Fraud and Abuse Control (HCFAC) program activities. About 78 percent of obligated funds were from mandatory HCFAC appropriations (budgetary resources provided in laws other than appropriatio...
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...
Medicare Information Technology: Centers for Medicare and Medicaid Services Needs to Pursue a Solution for Removing Social Security Numbers from Cards
GAO-13-761: Published: Sep 10, 2013. Publicly Released: Oct 17, 2013.
The Centers for Medicare and Medicaid Services (CMS)--which is the agency within the Department of Health and Human Services (HHS) responsible for administering Medicare--has not taken needed steps, such as designating a business owner and establishing a business case for an information technology (IT) project, that would result in selecting and implementing a technical solution for removing Socia...
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...
Patient Protection and Affordable Care Act: Status of CMS Efforts to Establish Federally Facilitated Health Care Exchanges and the Federal Data Services Hub
GAO-13-786T: Published: Jul 17, 2013. Publicly Released: Jul 17, 2013.
In brief, GAO's work found that CMS will operate a health insurance exchange in the 34 states that will not operate a state-based exchange for 2014. While CMS will retain full authority over each of these 34 FFEs, it planned to allow 15 of these states to assist it in carrying out certain FFE functions. However, the activities that CMS plans to carry out in these 15 exchanges, as well as in the 17...
Patient Protection and Affordable Care Act: Status of CMS Efforts to Establish Federally Facilitated Health Insurance Exchanges
GAO-13-601: Published: Jun 19, 2013. Publicly Released: Jun 19, 2013.
The Centers for Medicare & Medicaid Services (CMS) will operate a health insurance exchange in the 34 states that will not operate a state-based exchange for 2014. Of these 34 federally facilitated exchanges (FFE), 15 are in states expected to assist CMS in carrying out certain FFE functions. However, the activities that CMS plans to carry out in these 15 exchanges, as well as in the state-based e...
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...