Defense Health Care: Efforts to Manage Mental Health Care Benefits to CHAMPUS Beneficiaries

GAO discussed the Department of Defense's (DOD) management of mental health benefits under its Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). GAO noted that: (1) DOD-sponsored surveys conducted by a contractor have identified systematic problems affecting the quality of care being provided to children and adolescents in residential treatment centers; (2) as a result of the survey, many facilities have either withdrawn or been terminated from CHAMPUS, or corrected or promised to correct the deficiencies noted by contract surveyors; (3) contractor reviews of patient medical records for care provided in acute psychiatric hospitals, residential centers, and outpatient settings suggest that inappropriate admissions and continued stays are widespread, and facilities frequently fail to meet critical criteria for care; (4) DOD utilization review activities have had a significant effect on admissions and lengths of stays and have helped identify quality-of-care problems at psychiatric facilities; (5) DOD plans to improve the quality of mental health care provided to its beneficiaries by developing standards of care against which all CHAMPUS mental health care providers will be measured and by awarding a contract to monitor the quality of mental health care provided to CHAMPUS beneficiaries around the country; and (6) the Defense Criminal Investigative Service has 53 investigations underway involving CHAMPUS mental health care, principally of professional providers and facilities.