Medicare (21 - 30 of 63 items)
Nursing Homes: Stronger Complaint and Enforcement Practices Needed to Better Ensure Adequate Care
T-HEHS-99-89: Published: Mar 22, 1999. Publicly Released: Mar 22, 1999.
Pursuant to a congressional request, GAO discussed the effectiveness of complaint and enforcement practices to protect nursing home residents, and to ensure that homes participating in Medicare and Medicaid comply with federal standards, focusing on the: (1) effectiveness of states' complaint practices in protecting residents; (2) Health Care Financing Administration's (HCFA) role in establishing...
Health Insurance Standards: Implications of New Federal Law for Consumers, Insurers, Regulators
T-HEHS-98-114: Published: Mar 19, 1998. Publicly Released: Mar 19, 1998.
Pursuant to a congressional request, GAO discussed the implementation of the private insurance market provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).GAO noted that: (1) although HIPAA gives people losing coverage a guarantee of access to coverage in the individual market, consumers attempting to exercise this right have been hindered in some states by carrier...
Health Insurance Standards: New Federal Law Creates Challenges for Consumers, Insurers, Regulators
HEHS-98-67: Published: Feb 25, 1998. Publicly Released: Mar 10, 1998.
Pursuant to a congressional request, GAO reviewed the implementation of the Health Insurance Portability and Accountability Act (HIPAA), focusing on issues affecting: (1) consumers; (2) issuers of health coverage, including employers and insurance carriers; (3) state insurance regulators; and (4) federal regulators. GAO also reviewed efforts undertaken by federal agencies to address some of the co...
Medicaid Fraud and Abuse: Stronger Action Needed to Remove Excluded Providers From Federal Health Programs
HEHS-97-63: Published: Mar 31, 1997. Publicly Released: Apr 30, 1997.
Pursuant to a congressional request, GAO reviewed the Department of Health and Human Services (HHS) Inspector General's (OIG) process for excluding providers from federal health care programs.GAO noted that: (1) over the years, the OIG, working with state agencies, has excluded thousands of providers from participating in federal health care programs because of health care fraud, abuse, or quality...
Long-Term Care: Some States Apply Criminal Background Checks to Home Care Workers
PEMD-96-5: Published: Sep 27, 1996. Publicly Released: Oct 31, 1996.
Pursuant to a congressional request, GAO examined federal and state provisions for protecting vulnerable elderly and disabled persons from home care wokers with histories of crime and patient abuse, focusing on: (1) federal or state requirements for licensure, registration, or certification of home care workers and organizations; (2) the extent to which states have used the federally mandated regi...
Fraud and Abuse: Providers Excluded From Medicaid Continue to Participate in Federal Health Programs
T-HEHS-96-205: Published: Sep 5, 1996. Publicly Released: Sep 5, 1996.
GAO discussed whether the Department of Health and Human Services' (HHS) Office of Inspector General's (OIG) process for removing fraudulent health care providers from all federal health programs. GAO noted that: (1) weaknesses within HHS OIG allow sanctioned health care providers to remain in federal health care programs; (2) these weaknesses include lengthy delays in the OIG decision-making proc...
HEHS-96-11R: Published: Oct 2, 1995. Publicly Released: Oct 2, 1995.
Pursuant to a congressional request, GAO provided information on how the proposed MediGrant Program will affect Florida's federal Medicaid funding between fiscal years (FY) 1996 to 2002. GAO noted that: (1) Florida state officials estimate that Florida would receive $7.6 billion less under the proposed MediGrant program; (2) Florida is expected to match $30.6 billion under Medicaid spending law an...
Employer-Based Health Plans: Issues, Trends, and Challenges Posed by ERISA
T-HEHS-95-223: Published: Jul 25, 1995. Publicly Released: Jul 25, 1995.
GAO discussed the Employee Retirement Income Security Act of 1974 (ERISA), focusing on the: (1) proportion of workers in self-funded health insurance plans; (2) kinds of state actions preempted by ERISA; and (3) advantages of ERISA preemption to employers that offer health care coverage to their employees. GAO noted that: (1) nearly 40 percent of enrollees in employer-based health plans, or 44 mil...
Michigan Financing Arrangements
HEHS-95-146R: Published: May 5, 1995. Publicly Released: May 5, 1995.
Pursuant to a congressional request, GAO provided information on Michigan's 1995 Medicaid funding arrangements. GAO noted that: (1) Michigan has been among the most successful states in obtaining additional federal Medicaid funds; (2) since fiscal year (FY) 1991, Michigan has reduced its Medicaid costs by $1.8 billion due to a variety of financing partnerships with medical providers; (3) most fede...
Medicare/Medicaid: Data Bank Unlikely to Increase Collections From Other Insurers
HEHS-94-147: Published: May 6, 1994. Publicly Released: May 6, 1994.
GAO reviewed the Department of Health and Human Services' proposed Medicare/Medicaid data bank, focusing on whether it would: (1) improve existing Medicare and Medicaid fund recovery operations; and (2) realize greater savings beyond what the existing systems already achieve.GAO found that: (1) although Medicare and Medicaid programs could realize substantial savings if they had more complete info...