Medicare Equalization Factor Payments to Group Practice Prepayment Plans Should Be Stopped

GAO reviewed Medicare Part B equalization factor payments to Group Practice Prepayment Plans (GPPP) to determine whether the GPPP are consistent with either the statutory definition of reasonable costs under the Social Security Act or Department of Health and Human Services (HHS) implementing regulations. GPPP's are organizations that have a formal arrangement with the equivalent of three or more fulltime physicians to provide certain health services, generally not on a fee-for-service basis,to the plans' members.