Private Health Insurance:
Federal Role in Enforcing New Standards Continues to Evolve
GAO-01-652R: Published: May 7, 2001. Publicly Released: May 7, 2001.
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In recent years, Congress passed the Health Insurance Portability and Accountability Act (HIPAA) and three subsequent laws that create new federal standards for private health insurance which covers nearly 175 million Americans under the age of 65. These laws include standards guaranteeing access to health insurance for small employers and individuals with existing health conditions as well as requirements for health plans regarding mental health services, hospital care for mothers and newborns following childbirth, and reconstructive surgery following a mastectomy. Since HIPAA's enactment in 1996, federal agencies' enforcement roles have continued to evolve as they have established new or expanded existing enforcement activities to ensure compliance with standards under HIPAA and the related federal laws. Agency officials state that they have enough staff resources and expertise to carry out their current enforcement responsibilities. The Health Care Financing Administration's future role depends on the actions of states in enforcing the federal standards, as well as on congressional decisions about whether to reauthorize the Mental Health Parity Act or to enact additional patient protection legislation. In addition, the scope of the Department of Labor's future enforcement activities may depend on the extent of noncompliance found in its reviews of a nationwide random sample of employer-sponsored health plans. The audit results could cause Labor to refer noncompliant plans to Treasury for the imposition of an excise tax. Thus, although the agencies have been able to carry out their required enforcement roles, the continuing scope and extent of these roles will depend on the actions of employers, carriers, states, and Congress.
Jan 21, 2021
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Rural Hospital Closures:
Affected Residents Had Reduced Access to Health Care ServicesGAO-21-93: Published: Dec 22, 2020. Publicly Released: Jan 21, 2021. -
Health Care Funding:
Federal Obligations to and Funds Received by Certain Organizations Involved in Health-Related Services, 2016 through 2018GAO-21-188R: Published: Dec 21, 2020. Publicly Released: Jan 21, 2021.
Jan 14, 2021
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Medicaid:
Data Completeness and Accuracy Have Improved, Though Not All Standards Have Been MetGAO-21-196: Published: Jan 14, 2021. Publicly Released: Jan 14, 2021.
Jan 4, 2021
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Medicare Severe Wound Care:
Spending Declines May Reflect Site of Care Changes; Limited Information Is Available on QualityGAO-21-92: Published: Jan 4, 2021. Publicly Released: Jan 4, 2021.
Dec 22, 2020
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Defense Health Care:
Efforts to Ensure Beneficiaries Access Specialty Care and Receive Timely and Effective CareGAO-21-143: Published: Dec 22, 2020. Publicly Released: Dec 22, 2020.
Dec 16, 2020
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Medicaid Long-Term Services and Supports:
Access and Quality Problems in Managed Care Demand Improved OversightGAO-21-49: Published: Nov 16, 2020. Publicly Released: Dec 16, 2020.
Dec 14, 2020
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Drug Pricing Program:
HHS Uses Multiple Mechanisms to Help Ensure Compliance with 340B RequirementsGAO-21-107: Published: Dec 14, 2020. Publicly Released: Dec 14, 2020. -
Substance Use Disorder:
Reliable Data Needed for Substance Abuse Prevention and Treatment Block Grant ProgramGAO-21-58: Published: Dec 14, 2020. Publicly Released: Dec 14, 2020.
Dec 10, 2020
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Indian Health Service:
Actions Needed to Improve Oversight of Provider Misconduct and Substandard PerformanceGAO-21-97: Published: Dec 10, 2020. Publicly Released: Dec 10, 2020. -
Clinical Labs:
Studies Suggest Biopsy Specimen Misidentification and Contamination Errors Are InfrequentGAO-21-59: Published: Nov 10, 2020. Publicly Released: Dec 10, 2020.
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