Medicare (101 - 110 of 1,464 items)
Medicare Part D: CMS Has Implemented Processes to Oversee Plan Finder Pricing Accuracy and Improve Website Usability
GAO-14-143: Published: Jan 10, 2014. Publicly Released: Jan 10, 2014.
The Centers for Medicare & Medicaid Services (CMS), the agency within the Department of Health and Human Services (HHS) that administers Medicare, uses data checks and quality measures to oversee the accuracy of Part D plan pricing information on the Plan Finder interactive website. Part D sponsors may have multiple contracts with CMS to provide drug coverage, with each contract covering one or mo...
Clinical Data Registries: HHS Could Improve Medicare Quality and Efficiency through Key Requirements and Oversight
GAO-14-75: Published: Dec 16, 2013. Publicly Released: Dec 16, 2013.
Clinical data registries (CDR) have demonstrated a particular strength in assessing physician performance through their capacity to track and interpret trends in health care quality over time. Studies examining results reported by several long-established CDRs demonstrate the utility of CDR data sets for analyzing trends in both outcomes and treatments. CDR efforts to improve outcomes typically in...
Medicaid: CMS Should Ensure That States Clearly Report Overpayments
GAO-14-25: Published: Dec 6, 2013. Publicly Released: Dec 6, 2013.
States recovered $9.8 million in Medicaid overpayments, but they did not clearly report the overpayments and the return of the federal share to the Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS). Federal audits initially identified about $20.4 million in potential Medicaid overpayments across the 19 states with identified overpayments from J...
Medicare Program Integrity: Contractors Reported Generating Savings, but CMS Could Improve Its Oversight
GAO-14-111: Published: Oct 25, 2013. Publicly Released: Nov 25, 2013.
The Centers for Medicare and Medicaid Services (CMS) paid its Zone Program Integrity Contractors (ZPIC) about $108 million in 2012. ZPICs reported spending most of this funding on fraud case development, primarily for investigative staff, who in 2012 reported conducting about 3,600 beneficiary interviews, almost 780 onsite inspections, and reviews of more than 200,000 Medicare claims.ZPICs reporte...
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...
Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011-2012
GAO-14-21R: Published: Oct 24, 2013. Publicly Released: Oct 24, 2013.
Hospitals and health care professionals, such as physicians, were awarded a total of approximately $6.3 billion in Medicare electronic health records (EHR) incentive payments for 2012, which is more than twice the $2.3 billion awarded to hospitals and professionals for 2011. Almost half of eligible hospitals and less than a third of eligible professionals received Medicare EHR incentive payments f...
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...
U.S. Postal Service: Health and Pension Benefits Proposals Involve Trade-offs
GAO-13-872T: Published: Sep 26, 2013. Publicly Released: Sep 26, 2013.
GAO has reported that Congress needs to modify the U.S. Postal Service's (USPS) retiree health benefit payments in a fiscally responsible manner. GAO also has reported that USPS should prefund any unfunded retiree health benefit liability to the maximum extent that its finances permit. Deferring funding for postal retiree health benefits could increase costs for future ratepayers and increase the...