The Department of Veterans Affairs (VA) established an appointment scheduling process for the Veterans Community Care Program (VCCP) that allows up to 19 days to complete several steps from VA providers creating a referral to community care staff reviewing that referral. However, VA has not specified the maximum amount of time veterans should have to wait to receive care through the program. GAO

The Indian Health Service (IHS), like most federal agencies, must use appropriations in the year for which they are enacted. However, there has been interest in providing IHS with advance appropriation authority, which would give the agency authority to spend a specific amount 1 or more fiscal years after the fiscal year for which the appropriation providing it is enacted. Currently, the Departme

Under Medicaid managed care, managed care organizations (MCO) receive a periodic payment per beneficiary in order to provide health care services. Managed care has the potential to help states reduce Medicaid program costs and better manage the use of health care services. However, managed care payments also have the potential to create program integrity risks. GAO identified six types of payment

This supplemental material is a companion to GAO's report entitled Department of Health and Human Services: Office of Inspector General's Use of Agreements to Protect the Integrity of Federal Health Care Programs, GAO-18-322. The purpose of this supplemental material is to provide additional information from GAO's analysis of the Department of Health and Human Services Office of Inspector General

To help improve adherence to federal health care program requirements by entities that have allegedly engaged in certain acts, such as submitting false or fraudulent claims, the Department of Health and Human Services' Office of Inspector General (HHS-OIG) entered into 652 agreements with those entities from July 2005 to July 2017. Since 2010, two types of agreements have been used: Corporate Int

Certifying health conditions: The National Institute for Occupational Safety and Health (NIOSH)--an agency within the Department of Health and Human Services that administers the World Trade Center (WTC) Health Program--has developed policies, procedures, and guidance necessary for Health Program clinics and NIOSH to certify enrollees' WTC-related health conditions as being eligible for treatment

In four selected states, from 17 to 25 percent of enrollees who were covered by state expansions of Medicaid--authorized by the Patient Protection and Affordable Care Act (PPACA)--had diagnosed behavioral health conditions (mental health and substance use conditions) in 2014. Mental health conditions were more common than substance use conditions; from 11 to 20 percent of expansion enrollees were

Selected associations representing providers and patients most often cited the potential to improve or maintain quality of care as a significant factor that encourages the use of telehealth (providing clinical care remotely by two-way video) and remote patient monitoring (monitoring of patients outside of conventional settings) in Medicare. For example, according to officials from a provider asso

GAO's prior work has identified four Medicaid program integrity issues--where the program is vulnerable to improper payments such as those made for services that were not covered, were not medically necessary, or were not provided--as well as actions taken by the Centers for Medicare & Medicaid Services (CMS) to address the issues and additional actions that should be taken. (1) Enrollment Verifi

Available survey data show that most enrollees who obtained their coverage through the health insurance exchanges were satisfied overall with their qualified health plans (QHP) during the first few years that exchanges operated, according to five national surveys of QHP enrollees that GAO identified through its literature review. Specifically, most QHP enrollees who obtained their coverage throug