Physicians (61 - 70 of 477 items)
Medicare: Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions
GAO-12-966: Published: Sep 28, 2012. Publicly Released: Oct 31, 2012.
From 2004 through 2010, the number of self-referred and non-self-referred advanced imaging services--magnetic resonance imaging (MRI) and computed tomography (CT) services--both increased, with the larger increase among self-referred services. For example, the number of self-referred MRI services increased over this period by more than 80 percent, compared with an increase of 12 percent for non-se...
Medicaid: States Reported Billions More in Supplemental Payments in Recent Years
GAO-12-694: Published: Jul 20, 2012. Publicly Released: Aug 20, 2012.
States reported $32 billion in Medicaid supplemental payments during fiscal year 2010, but the exact amount of supplemental payments is unknown because state reporting was incomplete. On expenditure reports used to obtain federal funds filed with the Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS), states reported the following:A total of $17.6 bi...
Department of Health and Human Services: Opportunities for Financial Savings and Program Improvements in Medicare and Medicaid Remain
GAO-12-719T: Published: May 9, 2012. Publicly Released: May 9, 2012.
Over the past several years, GAO has made a number of recommendations to the Centers for Medicare & Medicaid Services (CMS)an agency within the Department of Health and Human Services (HHS)to increase savings in Medicare fee-for-service and Medicare Advantage (MA), which is a private plan alternative to the traditional Medicare fee-for-service program. Open recommendations that could y...
Medicare: Implementation of Financial Incentive Programs under Federal Fraud and Abuse Laws
GAO-12-355: Published: Mar 30, 2012. Publicly Released: Apr 30, 2012.
Certain financial incentive programs are permitted within the framework of federal fraud and abuse laws, but stakeholders GAO spoke with reported that the laws, regulations, and agency guidance have created challenges for program design and implementation. The Stark law and anti-kickback statute, which restrict financial relationships among providers, have statutory and regulatory exceptions and s...
Medicare Program Integrity: CMS Continues Efforts to Strengthen the Screening of Providers and Suppliers
GAO-12-351: Published: Apr 10, 2012. Publicly Released: Apr 23, 2012.
Medicare claims are screened against enrollment information, using automated enrollment-related prepayment edits, in an effort to prevent improper payments to ineligible providers and supplierssuch as those that are no longer active in the Medicare program or are not properly licensed to provide the services for which they have submitted claims. Officials with the contractors we interviewed...
Federal Antitrust Policy: Stakeholders' Perspectives Differed on the Adequacy of Guidance for Collaboration among Health Care Providers
GAO-12-291R: Published: Mar 16, 2012. Publicly Released: Apr 16, 2012.
Stakeholdershealth care industry groups and experts in antitrust lawhad different perspectives on the adequacy of three key aspects of antitrust guidance for health care provider collaboration. First, stakeholders perspectives differed on the sufficiency of guidance on clinical integration, which involves integrating clinical activities across providers in a collaborative arrange...
Drug Pricing: Research on Savings from Generic Drug Use
GAO-12-371R: Published: Jan 31, 2012. Publicly Released: Mar 1, 2012.
Our review identified articles that used varying approaches to estimate the savings associated with generic drug use in the United States. One group of studies estimated the savings in reduced drug costs that have accrued from the use of generics. For example, a series of studies estimated the total savings that have accrued to the U.S. health care system from substituting generic drugs for their...
Medicare: Lack of Price Transparency May Hamper Hospitals' Ability to Be Prudent Purchasers of Implantable Medical Devices
GAO-12-126: Published: Jan 13, 2012. Publicly Released: Feb 3, 2012.
From 2004 through 2009, expenditures for hospital IMD procedures increased from $16.1 billion to $19.8 billion, an increase of 4.3 percent per yeara rate equal to that of Medicare spending for other hospital procedures. While cardiac and orthopedic procedures accounted for nearly all IMD-related expenditures, orthopedic procedures accounted for most of the increase in such expenditures durin...
Pediatric Medical Devices: Provisions Support Development, but Better Data Needed for Required Reporting
GAO-12-225: Published: Dec 20, 2011. Publicly Released: Dec 20, 2011.
Certain characteristics unique to pediatric populationsincluding physiological differences from adult patients and challenges with recruiting pediatric participants for clinical trialsare barriers to developing medical devices for pediatric use cited by stakeholders. Given the unique characteristics of the pediatric population, and because the market for pediatric devices is smaller th...
Drug Shortages: FDA's Ability to Respond Should Be Strengthened
GAO-12-315T: Published: Dec 15, 2011. Publicly Released: Dec 15, 2011.
In brief, we found that the number of drug shortages has grown substantially in recent years, and FDA is constrained in its ability to protect the public health from the impact of these shortages. (1) The number of drug shortages has grown substantially since 2006, and many shortages involved generic injectable drugs. In total, 1,190 shortages were reported from January 1, 2001, through June 20, 2...