Medicare and Medicaid: Many Eligible People Not Enrolled in Qualified Medicare Beneficiary Program
HEHS-94-52
Published: Jan 20, 1994. Publicly Released: Jan 25, 1994.
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Highlights
Pursuant to a congressional request, GAO reviewed: (1) government efforts to publicize the Qualified Medicare Beneficiary (QMB) program; and (2) suggestions for increasing enrollment in QMB.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Congress should consider authorizing a demonstration in selected states to determine the effect on QMB enrollment of having SSA process QMB applications. This demonstration should be designed to determine whether applicants are more likely to apply for QMB benefits at SSA rather than a Medicaid office and to identify any additional resources SSA would need if the process was adopted nationwide. |
Closed – Not Implemented
|
No proposals to implement the matter for consideration by the Congress have been introduced in the Congress. While the Balanced Budget Act of 1997 expanded the income level at which Medicaid can pay cost sharing for Medicare beneficiaries, the Congress did not act on the matter for consideration. |
| To ensure that all eligible Medicaid beneficiaries who are also eligible for Medicare are enrolled in part A of Medicare, Congress may wish to consider requiring automatic part A buy-in for all QMB and regular Medicaid beneficiaries. |
Closed – Not Implemented
|
Although HCFA and the Congress have made numerous changes to Medicaid, no action was taken on this recommendation and no action is intended. |
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Topics
Eligibility determinationsFederal social security programsHealth care costsHealth care programsHealth insuranceHospital care servicesIncome maintenance programsMedicaidMedical expense claimsMedicarePublic assistance programsState-administered programsSupplemental security income