Health care programs (1 - 10 of 164 items)
VA's Health Care Budget: In Response to a Projected Funding Gap in Fiscal Year 2015, VA Has Made Efforts to Better Manage Future Budgets
GAO-16-584: Published: Jun 3, 2016. Publicly Released: Jun 3, 2016.
GAO found that two areas accounted for the Department of Veterans Affairs' (VA) fiscal year 2015 projected funding gap of $2.75 billion.Higher-than-expected obligations for VA's longstanding care in the community (CIC) programs—which allow veterans to obtain care from non-VA providers—accounted for $2.34 billion or 85 percent of VA's projected funding gap. VA officials expected that the Vetera...
Medicaid and CHIP: Increased Funding in U.S. Territories Merits Improved Program Integrity Efforts
GAO-16-324: Published: Apr 8, 2016. Publicly Released: May 9, 2016.
Eligibility and benefits for Medicaid and the state Children's Health Insurance Program (CHIP) in five U.S. territories—American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Guam, Puerto Rico and the U. S. Virgin Islands—differ from one another and from the states, generally reflecting the territories' unique circumstances. For example, Guam is the only territory that covers all...
Private Health Insurance: Federal Oversight Premiums and Enrollment for Consumer Operated and Oriented Plans in 2015
GAO-16-326: Published: Mar 10, 2016. Publicly Released: Mar 17, 2016.
The Centers for Medicare & Medicaid Services' (CMS) monitoring of the consumer governed, nonprofit health insurance issuers—known as consumer operated and oriented plans (CO-OPs)—evolved as the CO-OP program matured, and as 12 of the 23 CO-OPs ceased operations on or before January 1, 2016. CMS's initial monitoring activities, starting when it began to award CO-OP program loans in early 2012,...
Medicaid: Key Issues Facing the Program
GAO-15-677: Published: Jul 30, 2015. Publicly Released: Jul 30, 2015.
GAO identified four key issues facing the Medicaid program, based on prior work.Access to care : Medicaid enrollees report access to care that is generally comparable to that of privately insured individuals and better than that of uninsured individuals, but may have greater health care needs and greater difficulty accessing specialty and dental care.Transparency and oversight : The lack of comple...
Mental Health: Better Documentation Needed to Oversee Substance Abuse and Mental Health Services Administration Grantees
GAO-15-405: Published: May 12, 2015. Publicly Released: Jun 11, 2015.
The Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS) established criteria for the five grant programs covered by GAO's review that varied by program, but GAO found that CMHS did not document its application of criteria for about a third of the 16 grantees GAO reviewed. An example of how criteria varied by program is that one of the five...
Veterans Affairs Health Care: Addition to GAO's High Risk List and Actions Needed for Removal
GAO-15-580T: Published: Apr 29, 2015. Publicly Released: Apr 29, 2015.
To determine which federal government programs and functions should be designated high risk, GAO considers a number of factors. For example, it assesses whether the risk involves public health or safety, service delivery, national security, national defense, economic growth, or privacy or citizens' rights, or whether the risk could result in significantly impaired service, program failure, injury...
Children's Health Insurance Program: Effects on Coverage and Access, and Considerations for Extending Funding
GAO-15-348: Published: Feb 27, 2015. Publicly Released: Mar 30, 2015.
Assessments of national data GAO reviewed identify positive effects of the State Children's Health Insurance Program (CHIP), and the quality measures reported by states help identify areas needing improvement.A mandated evaluation of CHIP published in 2014 noted that CHIP enrollees (1) had substantially better access to care, service use, and preventive care when compared with uninsured children;...
Health Care Funding: Federal Obligations to and Expenditures by Selected Entities Involved in Health-Related Activities, 2010-2012
GAO-15-270R: Published: Mar 20, 2015. Publicly Released: Mar 25, 2015.
From fiscal year 2010 through 2012, the Department of Health and Human Services (HHS) and the U.S. Agency for International Development (USAID) reported obligating about $236 million to six organizations and their affiliates and member associations: Advocates for Youth, Guttmacher Institute, International Planned Parenthood Federation, Planned Parenthood Federation of America, Population Council,...
Mental Health: HHS Leadership Needed to Coordinate Federal Efforts Related to Serious Mental Illness
GAO-15-113: Published: Dec 18, 2014. Publicly Released: Feb 5, 2015.
Agencies identified 112 federal programs that generally supported individuals with serious mental illness in fiscal year 2013. The majority of these programs addressed broad issues, such as homelessness, that can include individuals with serious mental illness. The programs were spread across eight federal agencies: Department of Defense (DOD), Department of Education, Department of Health and Hum...
Federal Employees Health Benefits Program: Oversight of Carriers' Fraud and Abuse Programs
GAO-14-39: Published: Nov 14, 2013. Publicly Released: Dec 16, 2013.
The Office of Personnel Management (OPM) Healthcare & Insurance--Federal Employee Insurance Operations office, which we refer to as OPM's contracting office, monitors Federal Employees Health Benefits Program (FEHBP) carriers' compliance with requirements and other guidance for preventing, detecting, and eliminating fraud and abuse. These requirements include establishing a program to assess vulne...