Program management (11 - 20 of 127 items)
Indian Health Service: Increased Oversight Needed to Ensure Accuracy of Data Used for Estimating Contract Health Service Need
GAO-11-767: Published: Sep 23, 2011. Publicly Released: Sep 23, 2011.
The Indian Health Service (IHS), an agency in the Department of Health and Human Services (HHS), provides health care to American Indians and Alaska Natives. When care at an IHS-funded facility is unavailable, IHS's contract health services (CHS) program pays for care from external providers if the patient meets certain requirements and funding is available. The Patient Protection and Affordable C...
Drug Pricing: Manufacturer Discounts in the 340B Program Offer Benefits, but Federal Oversight Needs Improvement
GAO-11-836: Published: Sep 23, 2011. Publicly Released: Sep 23, 2011.
The Health Resources and Services Administration (HRSA), within in the Department of Health and Human Services (HHS), oversees the 340B Drug Pricing Program, through which participating drug manufacturers give certain entities within the health care safety net--known as covered entities--access to discounted prices on outpatient drugs. Covered entities include specified federal grantees and hospit...
Medicare Physician Feedback Program: CMS Faces Challenges with Methodology and Distribution of Physician Reports
GAO-11-720: Published: Aug 12, 2011. Publicly Released: Aug 12, 2011.
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) directed the Department of Health and Human Services (HHS) to develop a program to give physicians confidential feedback on the resources used to provide care to Medicare beneficiaries. In response, HHS's Centers for Medicare & Medicaid Services (CMS) has established and implemented the Physician Feedback Program by distribut...
World Trade Center Health Program: Potential Effects of Implementation Options
GAO-11-735R: Published: Aug 4, 2011. Publicly Released: Aug 4, 2011.
The James Zadroga 9/11 Health and Compensation Act of 2010 became law on January 2, 2011, and established a World Trade Center Health Program (WTCHP) to assume the functions of the World Trade Center (WTC) responder health programs beginning on July 1, 2011. From September 11, 2001, through fiscal year 2010, approximately $475 million in federal funds was made available for screening, monitoring,...
President's Emergency Plan for AIDS Relief: Program Planning and Reporting
GAO-11-785: Published: Jul 29, 2011. Publicly Released: Jul 29, 2011.
U.S. assistance through the President's Emergency Plan for AIDS Relief (PEPFAR) has helped provide treatment, care, and prevention services overseas to millions affected by HIV/AIDS. In 2008, Congress reauthorized PEPFAR with the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (2008 Leadership Act). The act requir...
Patient Protection and Affordable Care Act: Contracts Awarded and Consultants Retained by Federal Departments and Agencies to Assist in Implementing the Act
GAO-11-797R: Published: Jul 14, 2011. Publicly Released: Jul 14, 2011.
The Patient Protection and Affordable Care Act (PPACA), as amended by the Health Care and Education Reconciliation Act of 2010 (HCERA), contained provisions to increase access to health insurance coverage through: health insurance market reforms; an expansion of Medicaid eligibility; and the creation of health insurance exchanges to provide small employers and individuals access to coverage. In ad...
Patient Protection and Affordable Care Act: IRS Should Expand Its Strategic Approach to Implementation
GAO-11-719: Published: Jun 29, 2011. Publicly Released: Jun 29, 2011.
This report discusses the briefing we gave on June 8, 2011, as well as subsequent comments from the Internal Revenue Service (IRS). We gave this briefing in response to Congressional request that we assess IRS's planning to implement its responsibilities under the Patient Protection and Affordable Care Act (PPACA). The report (1) describes IRS's PPACA responsibilities and effective dates and (2) a...
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...
Medicare Contracting Reform: Agency Has Made Progress with Implementation, but Contractors Have Not Met All Performance Standards
GAO-10-71: Published: Mar 25, 2010. Publicly Released: Apr 26, 2010.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 significantly reformed contracting for payment of Medicare's $310 billion per year in fee-for-service claims. The Centers for Medicare & Medicaid Services (CMS) is transitioning claims administration to 19 new entities known as Medicare Administrative Contractors (MAC) and plans to complete the process ahead of October 1, 2...