Medicare (61 - 70 of 108 items)
Social Security: Long-Term Challenges Warrant Early Action
GAO-05-303T: Published: Feb 3, 2005. Publicly Released: Feb 3, 2005.
Social Security is the foundation of the nation's retirement income system, helping to protect the vast majority of American workers and their families from poverty in old age. However, it is much more than a retirement program and also provides millions of Americans with disability insurance and survivors' benefits. Over the long term, as the baby boom generation retires and as Americans continue...
Milwaukee Health Care Spending Compared to Other Metropolitan Areas: Geographic Variation in Spending for Enrollees in the Federal Employees Health Benefits Program
GAO-04-1000R: Published: Aug 18, 2004. Publicly Released: Aug 23, 2004.
Health care spending varies across the country due to differences in the use and price of health care services. Understanding the reasons for utilization and price variation may contribute to developing methods to control health care spending. This report provides preliminary results from our work on geographic variations in health care spending and prices. Congress asked us to examine geographic...
Medicare: CMS Needs Additional Authority to Adequately Oversee Patient Safety in Hospitals
GAO-04-850: Published: Jul 20, 2004. Publicly Released: Jul 20, 2004.
Hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) are considered in compliance with Medicare participation requirements. GAO examined the extent to which JCAHO's pre-2004 hospital accreditation process identified hospitals not complying with Medicare requirements, the potential of JCAHO's new process for improving the detection of deficiencies in Med...
Medicare Home Health: Payments to Most Freestanding Home Health Agencies More Than Cover Their Costs
GAO-04-359: Published: Feb 27, 2004. Publicly Released: Feb 27, 2004.
Under Medicare's home health prospective payment system (PPS), home health agencies (HHA) are paid a fixed amount, adjusted for differences in individual patients' expected care needs, for providing an episode (up to 60 days) of care. For this payment, HHAs provide therapy, skilled nursing, medical social service, and aide visits to patients in their homes. GAO previously reported that PPS payment...
Defense Health Care: Oversight of the Adequacy of TRICARE's Civilian Provider Network Has Weaknesses
GAO-03-592T: Published: Mar 27, 2003. Publicly Released: Mar 27, 2003.
During 2002, in testimony to the House Armed Services Committee, Subcommittee on Personnel, beneficiary groups described problems with access to care from TRICARE's civilian providers, and providers testified about their dissatisfaction with the TRICARE program, specifying low reimbursement rates and administrative burdens. The Bob Stump National Defense Authorization Act of 2003 required that GAO...
Medicare: Opportunities and Challenges in Contracting for Program Safeguards
GAO-01-616: Published: May 18, 2001. Publicly Released: Jun 11, 2001.
The Health Care Financing Administration (HCFA) chose 12 claims administration contractors in 1999 to act as program safeguard contractors (PSC) for Medicare. This report examines (1) HCFA's progress in implementing its PSC contracting authority and (2) whether HCFA could better manage the PSCs to ensure their most effective use. GAO found that HCFA is experimenting with different options for inte...
Medicare Improper Payments: Challenges for Measuring Potential Fraud and Abuse Remain Despite Planned Enhancements
T-AIMD/OSI-00-251: Published: Jul 12, 2000. Publicly Released: Jul 12, 2000.
Pursuant to a congressional request, GAO discussed the Health Care Financing Administration's (HCFA) efforts to improve the measurement of improper payments in the Medicare fee-for-service program.GAO noted that: (1) because it was not intended to include procedures designed specifically to identify all types of potential fraudulent and abusive activity, the current methodology does not provide an...
Organ Donation: Assessing Performance of Organ Procurement Organizations
T-HEHS-98-131: Published: Apr 8, 1998. Publicly Released: Apr 8, 1998.
GAO discussed: (1) whether the current standard for assessing the local organ procurement organizations' (OPO) effectiveness appropriately measures the extent to which OPOs are maximizing their ability to identify, procure, and transplant organs and tissue; and (2) alternatives to the current standard that could be more effective.GAO noted that: (1) the Health Care Financing Administration's (HCFA...
Defense Health Care: Uniformed Services Treatment Facility Health Program
HEHS-94-174: Published: Jun 2, 1994. Publicly Released: Jun 2, 1994.
Pursuant to a legislative requirement, GAO reviewed the health care agreements entered into between the Department of Defense (DOD) and the Uniformed Services Treatment Facilities (USTF), focusing on: (1) how the health care services and beneficiary cost-sharing requirements under USTF agreements compare to those of the other military health care delivery system components; and (2) the costs and o...
Health Care Alliances: Issues Relating To Geographic Boundaries
HEHS-94-139: Published: Apr 8, 1994. Publicly Released: Apr 8, 1994.
Pursuant to a congressional request, GAO reviewed the provisions of major health bills concerning the configuration of health care alliance boundaries, focusing on the: (1) features and procedures for establishing Metropolitan Statistical Areas (MSA); (2) experiences of two states that have established entities similar to alliances; and (3) potential effects of alliance boundaries on existing heal...