Health care programs (1 - 5 of 5 items) in Past Year
Patient Protection and Affordable Care Act: Final Results of Undercover Testing of the Federal Marketplace and Selected State Marketplaces for Coverage Year 2015
GAO-16-792: Published: Sep 9, 2016. Publicly Released: Sep 12, 2016.
Under the Patient Protection and Affordable Care Act (PPACA), health-insurance marketplaces are required to verify application information to determine eligibility for enrollment and, if applicable, determine eligibility for income-based subsidies or Medicaid. Verification steps include reviewing and validating an applicant's Social Security number, if one is provided; citizenship, status as a U.S...
Medicare: 2016 Payment Rates for Complex Wheelchair Accessories
GAO-16-840R: Published: Aug 31, 2016. Publicly Released: Aug 31, 2016.
GAO reviewed 2016 Medicare payment rates for complex wheelchair accessories—both the fully adjusted rates based on the durable medical equipment competitive bidding program (CBP) and the unadjusted rates for the same items. The Centers for Medicare & Medicaid Services (CMS)—the agency that oversees the Medicare program—classifies power wheelchairs into five groups ranging from wheelchairs wi...
Medicare Part B: Data on Coupon Discounts Needed to Evaluate Methodology for Setting Drug Payment Rates
GAO-16-643: Published: Jul 27, 2016. Publicly Released: Aug 26, 2016.
In 2015, manufacturers of 29 of the 50 high-expenditure Medicare Part B drugs GAO analyzed offered coupon programs, which reduce the costs patients incur for specific drugs. Part B drugs are typically administered by a physician. Coupon programs are prohibited in the Medicare program but are generally available to privately insured patients. GAO obtained data on coupon discounts for 18 drugs. GAO...
Indian Health Service: Actions Needed to Improve Oversight of Patient Wait Times
GAO-16-333: Published: Mar 29, 2016. Publicly Released: Apr 28, 2016.
The Indian Health Service (IHS) has not conducted any systematic, agency-wide oversight of the timeliness of primary care provided in its federally operated facilities. IHS has delegated primary responsibility for the oversight of care provided in its facilities to its area offices and has not set any agency-wide standards for patient wait times—including both how long it should take to schedule...
Rare Diseases: Too Early to Gauge Effectiveness of FDA's Pediatric Voucher Program
GAO-16-319: Published: Mar 2, 2016. Publicly Released: Mar 2, 2016.
It is too early to gauge whether the Food and Drug Administration's (FDA) pediatric voucher program has stimulated the development of drugs to treat or prevent rare pediatric diseases. Given that the typical drug development process often exceeds a decade, insufficient time has elapsed to determine whether the 3 year-old program has been effective. Any drug sponsors motivated by the program to att...