CHAMPUS Reform Initiative:
Unresolved Issues
T-HRD-87-4: Published: Mar 12, 1987. Publicly Released: Mar 12, 1987.
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GAO testified on the Department of Defense's (DOD) plans to change the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). The DOD CHAMPUS Reform Initiative objectives are to: (1) contain CHAMPUS costs for the government and beneficiaries; (2) increase beneficiary access to health care; (3) improve coordination between CHAMPUS and military treatment facilities; (4) ensure quality of care; and (5) simplify CHAMPUS administrative procedures. Although DOD believes that the Initiative will contain costs, it has not analyzed: (1) the potential from the cost-saving features; (2) the costs of program improvements; and (3) the costs of implementing administrative requirements. DOD also believes that the Initiative will improve beneficiary satisfaction, but both industry and beneficiary organizations raised concerns about whether this will occur. While the Initiative may reduce beneficiary claim-filing problems, it requires contractors to implement new features while retaining the current features and increases program complexity. Industry officials expressed concern that the Initiative's administrative requirements are excessive, overly restrictive, duplicative, and unclear and that coordination with military facilities will be difficult. Although a new DOD proposal addressed many of the concerns that industries raised by allowing offerers more flexibility in designing systems for new programs and submitting alternative cost proposals, GAO believes that DOD should evaluate the Initiative's demonstration phase to determine the effects of the Initiative on its objectives.
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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