Verifying Eligibility for Military Health Care: Some Progress Has Been Made, but Reliability Problems Remain
HRD-83-1
Published: Dec 01, 1982. Publicly Released: Dec 01, 1982.
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Highlights
GAO reviewed the Defense Enrollment Eligibility Reporting System (DEERS) to determine whether it would improve the eligibility determination process and provide accurate data on beneficiaries for use in military health resource planning. The DEERS was initiated specifically to accumulate accurate and timely data on all active duty and retired military sponsors, survivors, and dependents relating to their eligibility for health care benefits. This report discusses the problems experienced in the DEERS under the Uniformed Services Health Care System.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Defense | The Secretary of Defense should direct the military services to improve the accuracy and completeness of sponsor information submitted to the DEERS. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the military services to emphasize the implementation of procedures for identifying and enrolling dependents who have not been entered in the DEERS. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the military services to implement and monitor the application of more stringent verification procedures when determining the eligibility of children age 21 and over. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the military services to aggressively research the eligibility of dependents whose sponsor cannot be found in the DEERS. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the military services to more closely review the enrollment documents submitted to the DEERS to ensure their legibility and accuracy. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the DEERS Steering Group to monitor the DEERS Support Office efforts to promptly investigate and resolve erroneous information identified by system users. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the DEERS Steering Group to develop a comprehensive quality assurance program for assessing, on a systematic basis, the quality of the DEERS information and the actions needed to improve it. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the DEERS Steering Group to delay enrollment of dependents outside the United States until the enrollment problems discussed in the chapter are resolved. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the services to develop programs to educate sponsors on the need for reporting changes in dependent status when they occur. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the services to require that sponsors comply with the DEERS update procedures when processing dependent status changes in finance or emergency records. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
| Department of Defense | The Secretary of Defense should direct the DEERS Steering Group to establish standards on how quickly status changes must be updated in the DEERS and the degree of accuracy that the system must achieve in order for it it be considered effective. These standards should be used in assessing the system's overall reliability and cost effectiveness. |
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
|
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Topics
Data integrityEligibility determinationsHealth care planningInformation systemsMedical information systemsMilitary benefits claimsMilitary dependentsRecords managementMilitary health servicesDependents