Health insurance (71 - 80 of 335 items)
Medicare: Financial Outlook Poses Challenges for Sustaining Program and Adding Drug Coverage
GAO-02-643T: Published: Apr 17, 2002. Publicly Released: Apr 17, 2002.
The lack of outpatient prescription drug coverage may leave Medicare's most vulnerable beneficiaries with high out-of-pocket costs. Recent estimates suggest that, at any given time, more than a third of Medicare beneficiaries lack prescription drug coverage. The rest have some coverage through various sources--most commonly employer-sponsored health plans. Recent evidence indicates that this cover...
Medigap: Current Polices Contain Coverage Gaps, Undermine Cost Control Incentives
GAO-02-533T: Published: Mar 14, 2002. Publicly Released: Mar 14, 2002.
Medicare provides valuable and extensive health care coverage for 40 million elderly and disabled beneficiaries. Nevertheless, significant gaps leave some beneficiaries vulnerable to sizeable out-of-pocket expenses. Medicare provides no limit on out-of-pocket spending and no coverage for most outpatient prescription drugs. Most beneficiaries have supplemental coverage that helps to fill Medicare c...
Medicare: Communications with Physicians Can Be Improved
GAO-02-249: Published: Feb 27, 2002. Publicly Released: Feb 27, 2002.
Unlike other federal programs that make expenditures under the direct control of the government, Medicare constitutes a promise to pay for covered medical services provided to its beneficiaries by about one million providers. Given this open-ended entitlement, it is essential that appropriate and effective rules and policies be specified so that only necessary services are provided and reimbursed...
Medicare Physician Payments: Spending Targets Encourage Fiscal Discipline, Modifications Could Stabilize Fees
GAO-02-441T: Published: Feb 14, 2002. Publicly Released: Feb 14, 2002.
Congress implemented a physician fee schedule and a fee update formula to moderate spending growth relative to specified Medicare spending targets. These spending targets increase annually to reflect higher costs for physician services, the growth in the overall economy, and changes in the number of Medicare beneficiaries. Physician fees are adjusted for changes in the costs of providing services...
Medicare Subvention Demonstration: Pilot Satisfies Enrollees, Raises Cost and Management Issues for DOD Health Care
GAO-02-284: Published: Feb 11, 2002. Publicly Released: Feb 11, 2002.
The Department of Defense's (DOD) Medicare subvention demonstration tested alternate approaches to health care coverage for military retirees. Retirees could enroll in new DOD-run Medicare managed care plans, known as TRICARE Senior Prime, at six sites. The demonstration plan offered enrollees the full range of Medicare-covered services as well as additional TRICARE services, with minimal copaymen...
VA Health Care: VA Has Not Sufficiently Explored Alternatives for Optimizing Third-Party Collections
GAO-01-1157T: Published: Sep 20, 2001. Publicly Released: Sep 20, 2001.
The Department of Veterans Affairs (VA) has reversed the general decline in its third-party collections for the first time since fiscal year 1995. The fiscal year 2001 increase appears to be largely the result of VA's implementation of a new system, known as the reasonable charges billing system, which allowed VA to move from a flat-rate billing system to one that itemizes charges. However, long-s...
Medicare: Comments on HHS' Claims Administration Contracting Reform Proposal
GAO-01-1046R: Published: Aug 17, 2001. Publicly Released: Sep 10, 2001.
The Department of Health and Human Services (HHS) submitted a legislative proposal that would modify Medicare's contracting authority. This report examines (1) the current law and practice in Medicare claims administration contracting, (2) provisions in the proposal that would increase HHS Centers for Medicare and Medicaid Services' (CMS) contracting flexibility, and (3) the provisions that deviat...
Medicare Management: CMS Faces Challenges to Sustain Progress and Address Weaknesses
GAO-01-817: Published: Jul 31, 2001. Publicly Released: Aug 31, 2001.
Considering the complexity, the size, and the statutory constraints affecting the Medicare Program, some contend that the Health Care Financing Administration's (HCFA)--recently renamed the Centers for Medicare and Medicaid Services--management of Medicare has, on balance, been satisfactory. Others argue that HCFA's management has been unacceptable. HCFA's record has been mixed and the agency's ch...
Medigap Insurance: Plans Are Widely Available but Have Limited Benefits and May Have High Costs
GAO-01-941: Published: Jul 31, 2001. Publicly Released: Jul 31, 2001.
To protect themselves against large out-of-pocket expenses and help fill gaps in Medicare coverage, most beneficiaries buy supplemental insurance, known as Medigap; contribute to employer-sponsored health benefits to supplement Medicare coverage; or enroll in private Medicare+Choice plans rather than traditional fee-for-service Medicare. Because Medicare+Choice plans are not available everywhere...
Medicare Management: CMS Faces Challenges in Safeguarding Payments While Addressing Provider Needs
GAO-01-1014T: Published: Jul 26, 2001. Publicly Released: Jul 26, 2001.
In fiscal year 2000, Medicare made more than $200 billion in payments to hundreds of thousands of health care providers who served nearly 40 million beneficiaries. Because of the program's vast size and complexity, GAO has included Medicare on its list of government areas at high risk for waste, fraud, abuse, and mismanagement. GAO first included Medicare on that list in 1990, and it remains there...