Skip to main content

Savings Possible by Modifying Medicare's Waiver of Liability Rules

HRD-83-38 Published: Mar 04, 1983. Publicly Released: Mar 04, 1983.
Jump To:
Skip to Highlights

Highlights

GAO reported on proposed legislation to modify Medicare's waiver of liability provision with respect to payments to hospitals, skilled nursing facilities, and home health agencies. The waiver of liability provision protects both beneficiaries and providers from having to pay for services they receive that Medicare will not pay for. The Administration proposed legislation that would delete the authorization to waive provider liability for claims for services submitted under the Medicare part A program. Under the proposal, health care providers would no longer be paid when Medicare determined that a service was medically unreasonable, unnecessary, or custodial in nature. The proposal would not affect the protection afforded beneficiaries.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services (HHS) should direct the Administrator, HCFA, to establish more stringent eligibility requirements for the application of waiver of liability for health care providers under part A of Medicare.
Closed – Implemented
HCFA issued regulations in February 1986 which implemented this recommendation.

Full Report

Office of Public Affairs

Topics

Budget cutsEligibility criteriaHealth care cost controlMedicareHealth care servicesLiability (legal)Proposed legislationWaiversHealth careHospitals