Program evaluation (41 - 50 of 435 items)
Health Care Fraud and Abuse Control Program: Improvements Needed in Controls over Reporting Deposits and Expenditures
GAO-11-446: Published: May 10, 2011. Publicly Released: Jun 9, 2011.
To help combat fraud and abuse in health care programs, including Medicare and Medicaid, Congress enacted the Health Care Fraud and Abuse Control (HCFAC) program as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA requires that the Departments of Health and Human Services (HHS) and Justice (DOJ) issue a joint annual report to Congress on amounts deposited to a...
Federal Recovery Coordination Program: Enrollment, Staffing, and Care Coordination Pose Significant Challenges
GAO-11-572T: Published: May 13, 2011. Publicly Released: May 13, 2011.
This testimony discusses the challenges facing the Federal Recovery Coordination Program (FRCP)--a program that was jointly developed by the Departments of Defense (DOD) and Veterans Affairs (VA) following critical media reports of deficiencies in the provision of outpatient services at Walter Reed Army Medical Center. This program was established to assist "severely wounded, ill, and injured" Ope...
Medicaid and CHIP: Reports for Monitoring Children's Health Care Services Need Improvement
GAO-11-293R: Published: Apr 5, 2011. Publicly Released: Apr 5, 2011.
Medicaid and the Children's Health Insurance Program (CHIP)--two joint federal-state health care programs for low-income families and children--play a critical role in addressing the health care needs of children. In 2008, more than 36 million children in the United States received health care coverage through Medicaid or CHIP. Like all children, children covered by Medicaid and CHIP may have heal...
DOD and VA Health Care: Federal Recovery Coordination Program Continues to Expand but Faces Significant Challenges
GAO-11-250: Published: Mar 23, 2011. Publicly Released: Mar 23, 2011.
In 2007, following reports of poor case management for outpatients at Walter Reed Army Medical Center, the Departments of Defense (DOD) and Veterans Affairs (VA) jointly developed the Federal Recovery Coordination Program (FRCP) to coordinate the clinical and nonclinical services needed by severely wounded, ill, and injured servicemembers and veterans. The FRCP, which continues to expand, is admin...
Medicare Part D: CMS Conducted Fraud and Abuse Compliance Plan Audits, but All Audit Findings Are Not Yet Available
GAO-11-269R: Published: Feb 18, 2011. Publicly Released: Mar 21, 2011.
The Medicare Part D program, administered by the Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS), provides a voluntary, outpatient prescription drug benefit for eligible individuals 65 years and older and eligible individuals with disabilities. CMS contracts with private companies--such as health insurance companies and companies that manage pharmacy b...
Medicare: Program Remains at High Risk Because of Continuing Management Challenges
GAO-11-430T: Published: Mar 2, 2011. Publicly Released: Mar 2, 2011.
In the February 2011 High-Risk Series update, GAO continued designation of Medicare as a high-risk program because its complexity and susceptibility to improper payments, combined with its size, have led to serious management challenges. In 2010, Medicare covered 47 million people and had estimated outlays of $509 billion. The Centers for Medicare & Medicaid Services (CMS) has estimated fiscal yea...
Electronic Prescribing: CMS Should Address Inconsistencies in Its Two Incentive Programs That Encourage the Use of Health Information Technology
GAO-11-159: Published: Feb 17, 2011. Publicly Released: Feb 17, 2011.
Congress established two CMS-administered programs--the Electronic Prescribing Program and the Electronic Health Records (EHR) Program--that provide incentive payments to eligible Medicare providers who adopt and use health information technology, and penalties for those who do not. The Medicare Improvements for Patients and Providers Act of 2008 required GAO to report on the Electronic Prescribin...
Hearing Loss Prevention: Improvements to DOD Hearing Conservation Programs Could Lead to Better Outcomes
GAO-11-114: Published: Jan 31, 2011. Publicly Released: Jan 31, 2011.
Exposure to hazardous noise can have negative implications for both servicemember health and readiness. Moreover, in fiscal year 2009, some of the most common impairments for veterans receiving Veterans Affairs (VA) disability benefits were hearing related, as annual payments for such conditions exceeded $1.1 billion. To examine Department of Defense (DOD) efforts to prevent hearing loss, GAO is r...
Medicare: CMS Needs to Collect Consistent Information from Quality Improvement Organizations to Strengthen Its Establishment of Budgets for Quality of Care Reviews
GAO-11-116R: Published: Dec 6, 2010. Publicly Released: Dec 22, 2010.
Medicare funds health care services for more than 46 million beneficiaries. The Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare--contracts with private organizations known as Quality Improvement Organizations (QIO) to, among other core functions, improve the quality of care for Medicare beneficiaries. CMS contracts with one QIO for each of the 50 states, the Di...
Respite Care: Grants and Cooperative Agreements Awarded to Implement the Lifespan Respite Care Act
GAO-11-28R: Published: Oct 22, 2010. Publicly Released: Oct 22, 2010.
Individuals who are limited in their capacity for self-care because of a physical, cognitive, or mental disability or condition that results in a functional impairment may depend on family caregivers for assistance with routine daily activities. According to a 2009 study by the National Alliance for Caregiving and AARP, an estimated 65.7 million people, or 29 percent of the population, had served...