state relations (41 - 50 of 184 items)
Medicaid: Intergovernmental Transfers Have Facilitated State Financing Schemes
GAO-04-574T: Published: Mar 18, 2004. Publicly Released: Mar 18, 2004.
Medicaid, the federal-state health financing program for many of the nation's most vulnerable populations, finances health care for an estimated 53 million lowincome Americans, at a cost of $244 billion in 2002. Congress structured Medicaid as a shared fiduciary responsibility of the federal government and the states, with the federal share of each state's Medicaid payments determined by a formula...
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 Formula: Differences in Funding Ability among States Often Are Widened
GAO-03-620: Published: Jul 10, 2003. Publicly Released: Aug 11, 2003.
A primary goal in establishing Medicaid's statutory formula, whereby states with lower per capita incomes (PCI) receive higher rates of federal reimbursement for program costs, was to narrow differences among states in their ability to fund Medicaid services. States' ability to fund services depends on their financial resources in relation to their number of and costs to serve people in poverty. G...
Long-Term Care: Federal Oversight of Growing Medicaid Home and Community-Based Waivers Should Be Strengthened
GAO-03-576: Published: Jun 20, 2003. Publicly Released: Jul 7, 2003.
Home and community-based settings have become a growing part of states' Medicaid long-term care programs, serving as an alternative to care in institutional settings, such as nursing homes. To cover such services, however, states often obtain waivers from certain federal statutory requirements. GAO was asked to review (1) trends in states' use of Medicaid home and community-based service (HCBS) wa...
Newborn Screening: Characteristics of State Programs
GAO-03-449: Published: Mar 17, 2003. Publicly Released: Apr 16, 2003.
Each year state newborn screening programs test 4 million newborns for disorders that require early detection and treatment to prevent serious illness or death. GAO was asked to provide the Congress with information on the variations among state newborn screening programs, including information on criteria considered in selecting disorders to include in state programs, education for parents and pr...
Medicaid and SCHIP: States Use Varying Approaches to Monitor Children's Access to Care
GAO-03-222: Published: Jan 14, 2003. Publicly Released: Feb 14, 2003.
Over 25 million children have health insurance coverage through Medicaid or the State Children's Health Insurance Program (SCHIP). Coverage alone, however, does not guarantee that services will be available or that children will receive needed care. GAO was asked to evaluate states' efforts to facilitate and monitor access to primary and preventive services for children in these jointly funded fed...
Children's Health Insurance: Inspector General Reviews Should Be Expanded to Further Inform the Congress
GAO-02-512: Published: Mar 29, 2002. Publicly Released: Mar 29, 2002.
Congress created the State Children's Health Insurance Program (SCHIP) in 1997 to reduce the number of uninsured children in families with incomes that are too high to qualify for Medicaid. Financed jointly by the states and the federal government, SCHIP encourages state participation by offering a higher federal matching rate than the Medicaid program. Concerns have been raised that states might...
Nursing Homes: Federal Efforts to Monitor Resident Assessment Data Should Complement State Activities
GAO-02-279: Published: Feb 15, 2002. Publicly Released: Mar 18, 2002.
Nursing homes that participate in Medicare and Medicaid must periodically assess the needs of residents in order to develop an appropriate plan of care. Such resident assessments are known as the minimum data set (MDS). According to officials in the 10 states with MDS accuracy review programs in operation as of January 2001, these programs were established to set Medicaid payments and identify qua...
Medicaid: HCFA Reversed Its Position and Approved Additional State Financing Schemes
GAO-02-147: Published: Oct 30, 2001. Publicly Released: Nov 2, 2001.
Some states have taken advantage of the flexibility that Congress built into the Medicaid program by devising schemes that inappropriately boost the federal share of program expenditures. These schemes were adding billions of dollars a year to federal Medicaid costs without the states paying their statutorily specified share of program costs. Moreover, some of the federal funds were being spent fo...
VA Long-Term Care: Oversight of Community Nursing Homes Needs Strengthening
GAO-01-768: Published: Jul 27, 2001. Publicly Released: Sep 7, 2001.
The Department of Veterans Affairs (VA) spent about $1.9 billion--or about 10 percent of its health care budget--to provide nursing home care to veterans in fiscal year 2000. VA will likely see increasing demand for nursing home care during the next decade. The number of veterans age 85 and older is expected to triple--from 422,000 veterans in 2000 to nearly 1.3 million in 2010. Among the very old...