Medicare: Uncertainties Surround Proposal To Expand Prepaid Health Plan Contracting
HRD-88-14
Published: Nov 02, 1987. Publicly Released: Nov 17, 1987.
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Highlights
Pursuant to a congressional request, GAO reviewed a Department of Health and Human Services (HHS) proposal seeking legislative authority to contract with employer-based health plans to provide Medicare benefits to the employers' retirees.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| If the House Ways and Means Committee, Subcommittee on Health, considers the HHS Medicare-insured group proposal, it should consider deferring authorizing implementation until HHS demonstrates that the Medicare-insured group rate-setting methods and beneficiary and program safeguards are reasonable and adequate. |
Closed – Implemented
|
Section 4015 of the Omnibus Budget Reconciliation Act of 1987 limited HHS to funding three Medicare insured group demonstration projects and required that they be evaluated before program expansion. |
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Topics
Employee medical benefitsEmployee retirement plansHealth care cost controlHealth insuranceHealth maintenance organizationsMedicareProposed legislationRetireesRetirement benefitsCapitation (medical care)