Preventing Abusive Medicare Billing
HEHS-95-260R: Published: Sep 5, 1995. Publicly Released: Sep 5, 1995.
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Pursuant to a congressional request, GAO discussed its recommendations for preventing abusive Medicare billing and whether the recommendations can be implemented legislatively. GAO noted that: (1) Medicare law could be amended to require the Department of Health and Human Services (HHS) to establish the requirements recommended, as well as establish a higher limit on the amount that Medicare will recognize as reasonable for therapy services; (2) expense claim limits could be set at the amount established under Medicare's part B fee schedules for therapy services; (3) establishing an upper limit would partially define billable units of service, since the procedure codes for occupational and speech therapy do not define the amount of time the codes cover; and (5) proposals have been made to require nursing homes to bill for the services provided to their residents, whether payment is sought from part A or part B fee schedules.
Feb 4, 2019
Medicaid:
CMS Action Needed to Ensure Compliance with Abortion Coverage RequirementsGAO-19-159: Published: Jan 4, 2019. Publicly Released: Feb 4, 2019.
Jan 28, 2019
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Health Insurance Exchanges:
Claims Costs and Federal and State Policies Drove Issuer Participation, Premiums, and Plan DesignGAO-19-215: Published: Jan 28, 2019. Publicly Released: Jan 28, 2019.
Jan 22, 2019
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Medicare:
Voluntary and Mandatory Episode-Based Payment Models and Their ParticipantsGAO-19-156: Published: Dec 21, 2018. Publicly Released: Jan 22, 2019.
Jan 15, 2019
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Health Information Technology:
Approaches and Challenges to Electronically Matching Patients' Records across ProvidersGAO-19-197: Published: Jan 15, 2019. Publicly Released: Jan 15, 2019.
Dec 21, 2018
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Medicare Fee-For-Service:
Information on the Second Year of Nationwide Reduced Payment Rates for Durable Medical EquipmentGAO-19-153R: Published: Dec 21, 2018. Publicly Released: Dec 21, 2018.
Dec 13, 2018
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Medicare:
Payments for Certain Long-Term Care Hospitals that Specialize in Spinal Cord TreatmentGAO-19-141: Published: Dec 13, 2018. Publicly Released: Dec 13, 2018.
Dec 10, 2018
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Indian Health Service:
Spending Levels and Characteristics of IHS and Three Other Federal Health Care ProgramsGAO-19-74R: Published: Dec 10, 2018. Publicly Released: Dec 10, 2018.
Nov 30, 2018
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Medicare Laboratory Tests:
Implementation of New Rates May Lead to Billions in Excess PaymentsGAO-19-67: Published: Nov 30, 2018. Publicly Released: Nov 30, 2018. -
Orphan Drugs:
FDA Could Improve Designation Review Consistency; Rare Disease Drug Development Challenges ContinueGAO-19-83: Published: Nov 30, 2018. Publicly Released: Nov 30, 2018.
Nov 27, 2018
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Defense Health Care:
Additional Assessments Needed to Better Ensure an Efficient Total WorkforceGAO-19-102: Published: Nov 27, 2018. Publicly Released: Nov 27, 2018.
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