Medicare (41 - 50 of 108 items)
State Children's Health Insurance Program: Program Structure, Enrollment and Expenditure Experiences, and Outreach Approaches for States That Cover Adults
GAO-08-50: Published: Nov 26, 2007. Publicly Released: Dec 20, 2007.
In 2006 about 4.5 million individuals were enrolled in the State Children's Health Insurance Program (SCHIP). Congress created SCHIP with the goal of significantly reducing the number of low-income uninsured children. Under certain circumstances, states may also cover adults, and in June 2006 about 349,000 adults were enrolled. Each state receives an annual allotment of federal funds, available as...
Prescription Drugs: Trends in Usual and Customary Prices for Drugs Frequently Used by Medicare and Non-Medicare Health Insurance Enrollees
GAO-07-1201R: Published: Sep 7, 2007. Publicly Released: Oct 9, 2007.
Prescription drug spending as a share of national health expenditures increased from 8.9 percent in 2000 to 10.1 percent in 2005--among the fastest growing segments of health care expenditures--and prescription drug prices outpaced inflation during the same period. Rising prescription drug prices can affect consumers, employers, and federal and state governments. Federal policymakers are particula...
Medicare Advantage: Required Audits of Limited Value
GAO-07-945: Published: Jul 30, 2007. Publicly Released: Jul 30, 2007.
In fiscal year 2006, the Centers for Medicare & Medicaid Services (CMS) spent over $51 billion on the Medicare Advantage program, which serves as an alternative to the traditional fee-for-service program. Under the Medicare Advantage program, companies wishing to participate must annually submit bids (effective with contract year 2006) that identify the health services the company will provide to...
End-Stage Renal Disease: Medicare Should Pay a Bundled Rate for All ESRD Items and Services
GAO-07-1050T: Published: Jun 26, 2007. Publicly Released: Jun 26, 2007.
GAO provided to Congress, as requested, a statement for the record on Medicare payments for certain drugs provided to patients with end-stage renal disease (ESRD), a condition of permanent kidney failure. Through Medicare's ESRD benefit, patients receive a treatment known as dialysis, which removes excess fluids and toxins from the bloodstream. Patients also receive items and services related to t...
Retiree Health Benefits: Majority of Sponsors Continued to Offer Prescription Drug Coverage and Chose the Retiree Drug Subsidy
GAO-07-572: Published: May 31, 2007. Publicly Released: May 31, 2007.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) created a prescription drug benefit for beneficiaries, called Medicare Part D, beginning in January 2006. The MMA resulted in options for sponsors of employment-based prescription drug benefits, such as a federal subsidy payment--the retiree drug subsidy (RDS)--when sponsors provide benefits meeting certain MMA requir...
Federal Employees Health Benefits Program: Premiums Continue to Rise, but Rate of Growth Has Recently Slowed
GAO-07-873T: Published: May 18, 2007. Publicly Released: May 18, 2007.
Average health insurance premiums for plans participating in the Federal Employees Health Benefits Program (FEHBP) have risen each year since 1997. These growing premiums result in higher costs to the federal government and plan enrollees. The Office of Personnel Management (OPM) oversees FEHBP, negotiating benefits and premiums and administering reserve accounts that may be used to cover plans' u...
Medicare Part D Low-Income Subsidy: Progress Made in Approving Applications, but Ability to Identify Remaining Individuals Is Limited
GAO-07-858T: Published: May 8, 2007. Publicly Released: May 8, 2007.
To help the elderly and disabled with prescription drug costs, the Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003, which created a voluntary outpatient prescription drug benefit (Medicare Part D). A key element of the prescription drug benefit is the low-income subsidy, or "extra help," available to Medicare beneficiaries with limited income and re...
Medicare: Improvements Needed to Address Improper Payments for Medical Equipment and Supplies
GAO-07-59: Published: Jan 31, 2007. Publicly Released: Mar 6, 2007.
The Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare--estimated that the program made about $700 million in improper payments for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) from April 1, 2005, through March 31, 2006. To protect Medicare from improper DMEPOS payments, CMS relies on three Program Safeguard Contractors (PSC), and four...
Prescription Drugs: Oversight of Drug Pricing in Federal Programs
GAO-07-481T: Published: Feb 9, 2007. Publicly Released: Feb 9, 2007.
Several federal programs help pay for or reduce the costs of prescription drugs for eligible individuals and entities. Three examples are the Medicaid drug rebate program, part of the joint federal-state Medicaid program that finances medical services for certain low-income people; the 340B drug pricing program, which provides discounted drug prices to certain eligible entities such as community h...
End-Stage Renal Disease: Bundling Medicare's Payment for Drugs with Payment for All ESRD Services Would Promote Efficiency and Clinical Flexibility
GAO-07-77: Published: Nov 13, 2006. Publicly Released: Dec 6, 2006.
Medicare covers dialysis--a process that removes excess fluids and toxins from the bloodstream--for most individuals with end-stage renal disease (ESRD), a condition of permanent kidney failure. The Centers for Medicare & Medicaid Services (CMS) pays for certain dialysis services under a type of bundled rate, called a composite rate, and, for certain dialysis-related drugs, pays a separate rate pe...