Government Loses Revenue Because of Low Medical Care Charges to Liable Third Parties
AFMD-82-2
Published: Dec 16, 1981. Publicly Released: Dec 16, 1981.
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Highlights
The Government is authorized by the Federal Medical Care Recovery Act to recover the cost of care provided or paid for when any of its beneficiaries require medical treatment because of the negligent actions of a third party. GAO conducted a review to determine if the Department of Defense (DOD) and the Veterans Administration (VA) were complying with the rate-setting provision of the Act.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Defense | The Secretary of Defense and the Administrator of Veterans Affairs should develop, for the Office of Management and Budget, medical care recovery rates to be charged liable third parties which more accurately reflect the actual cost of care provided in their hospitals. To this end, as cost and workload data become available during the year: (1) actual costs per in-patient day and per out-patient visit should be developed and compared with amounts being charged; (2) variances should be determined and analyzed; and (3) recovery rates should be adjusted during the year to conform to actual results. |
Please call 202/512-6100 for information.
|
| Veterans Administration | The Secretary of Defense and the Administrator of Veterans Affairs should develop, for the Office of Management and Budget, medical care recovery rates to be charged liable third parties which more accurately reflect the actual cost of care provided in their hospitals. To this end, as cost and workload data become available during the year: (1) actual costs per in-patient day and per out-patient visit should be developed and compared with amounts being charged; (2) variances should be determined and analyzed; and (3) recovery rates should be adjusted during the year to conform to actual results. |
Please call 202/512-6100 for information.
|
| Office of Management and Budget | The Director of the Office of Management and Budget should monitor the development of the medical care recovery rates to be charged liable third parties and revise recovery rates accordingly, if he believes that the rates are reasonable. |
Please call 202/512-6100 for information.
|
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Topics
Collection proceduresFinancial managementHealth care cost controlHealth resources utilizationHospital care servicesLiability (legal)Medical economic analysisMedical services ratesMilitary hospitalsVeterans hospitals