State-administered programs (21 - 30 of 240 items)
Medicaid Fraud and Abuse: CMS's Commitment to Helping States Safeguard Program Dollars Is Limited
GAO-05-855T: Published: Jun 28, 2005. Publicly Released: Jun 28, 2005.
Today's hearing addresses fraud and abuse control in Medicaid, a program that provides health care coverage for eligible low-income individuals and is jointly financed by the federal government and the states. In fiscal year 2003, Medicaid covered nearly 54 million people and the program's benefit payments totaled roughly $261 billion, of which the federal share was about $153 billion. States are...
Medicaid: States' Efforts to Maximize Federal Reimbursements Highlight Need for Improved Federal Oversight
GAO-05-836T: Published: Jun 28, 2005. Publicly Released: Jun 28, 2005.
Medicaid--the federal-state health care financing program covering almost 54 million low-income people at a cost of $276 billion in fiscal year 2003--is by its size and structure at significant risk of waste and exploitation. Because of challenges inherent in overseeing the program, which is administered federally by the Centers for Medicare & Medicaid Services (CMS), GAO added Medicaid to its lis...
Medicaid Financing: States' Use of Contingency-Fee Consultants to Maximize Federal Reimbursements Highlights Need for Improved Federal Oversight
GAO-05-748: Published: Jun 28, 2005. Publicly Released: Jun 28, 2005.
Medicaid--the federal-state health care financing program covering nearly 54 million low-income people at a cost of $276 billion in fiscal year 2003--is by its size and structure at risk of waste and exploitation. Because of challenges inherent in overseeing the program, administered federally by the Centers for Medicare & Medicaid Services (CMS), GAO in 2003 added Medicaid to its list of high-ris...
Health Centers And Rural Clinics: State and Federal Implementation Issues for Medicaid's New Payment System
GAO-05-452: Published: Jun 17, 2005. Publicly Released: Jun 17, 2005.
The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) established a prospective payment system (PPS) for Medicaid payments to Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC), giving providers a financial incentive to operate efficiently. BIPA requires that BIPA PPS rates be adjusted for inflation and changes in scope of services. States a...
Food Stamp Program: Farm Bill Options Ease Administrative Burden, but Opportunities Exist to Streamline Participant Reporting Rules among Programs
GAO-04-916: Published: Sep 16, 2004. Publicly Released: Sep 16, 2004.
Many individuals familiar with the Food Stamp Program view its rules as unnecessarily complex, creating an administrative burden for participants and caseworkers. In addition many participants receive benefits from other programs that have different program rules, adding to the complexity of accurately determining program benefits and eligibility. The 2002 Farm Bill introduced new options to help...
Medicaid Waivers: HHS Approvals of Pharmacy Plus Demonstrations Continue to Raise Cost and Oversight Concerns
GAO-04-480: Published: Jun 30, 2004. Publicly Released: Jul 30, 2004.
Under section 1115 of the Social Security Act, the Secretary of Health and Human Services may waive certain Medicaid requirements for states seeking to deliver services through demonstration projects. By policy, these demonstrations must not increase federal spending. GAO has previously reported concerns with HHS's approval process. GAO was asked to provide information on a new Medicaid section 11...
Medicaid and SCHIP: States' Premium and Cost Sharing Requirements for Beneficiaries
GAO-04-491: Published: Mar 31, 2004. Publicly Released: Apr 30, 2004.
Over 50 million low-income adults and children receive health insurance coverage through Medicaid and the State Children's Health Insurance Program (SCHIP). Federal law allows states to require beneficiary contributions, such as premiums and cost sharing (coinsurance, copayments, and deductibles), for at least some Medicaid and SCHIP beneficiaries. GAO was asked to (1) identify and compare states'...
Medicare Savings Programs: Results of Social Security Administration's 2002 Outreach to Low-Income Beneficiaries
GAO-04-363: Published: Mar 26, 2004. Publicly Released: Mar 26, 2004.
To assist low-income beneficiaries with their share of premiums and other out-of-pocket costs associated with Medicare, Congress has created four Medicare savings programs. Historic low enrollment in these programs has been attributed to several factors, including lack of awareness about the programs, and cumbersome eligibility determination and enrollment processes through state Medicaid programs...
Medicaid: Improved Federal Oversight of State Financing Schemes Is Needed
GAO-04-228: Published: Feb 13, 2004. Publicly Released: Mar 16, 2004.
For years, some states have taken advantage of a loophole in Medicaid law that allows them to claim billions of dollars in excessive federal matching funds by exploiting the "upper payment limit" (UPL), which is intended to be a ceiling on federal cost sharing. Congress and the Centers for Medicare & Medicaid Services (CMS) acted to curtail UPL financing schemes through law in 2000 and regulation...
Medicaid Nursing Home Payments: States' Payment Rates Largely Unaffected by Recent Fiscal Pressures
GAO-04-143: Published: Oct 17, 2003. Publicly Released: Nov 26, 2003.
Almost half of all Americans over the age of 65 will rely on nursing home care at some point in their lives, and two in three nursing home residents have their care covered at least in part by Medicaid. Under Medicaid, states set nursing home payment rates and the federal government reimburses a share of state spending. According to the most recently available data, Medicaid nursing home expenditu...