To increase the accessibility of primary and preventive health services for low-income people living in medically underserved areas, Congress made federally qualified health centers and rural health clinics eligible for Medicaid payments. Since 1989, federal law has required Medicaid to reimburse both the centers and the clinics on the basis of reasonable costs they incurred in providing services

Medicare is a popular program that millions of Americans depend on for covering their essential health needs. However, the management of the program has fallen short of expectations because it has not always appropriately balanced or satisfied the needs of beneficiaries, providers, and taxpayers. For example, stakeholders expect that Medicare will price services prudently; that providers will be

Medicare faces many challenges. The overarching issue is how to sustain the program for future generations. Meeting that challenge will require difficult decisions that will affect beneficiaries, providers, and taxpayers. However, the financing issue should not obscure other important challenges. Medicare's current cost-sharing arrangements do not encourage the efficient use of services without d

In 1999, nearly 10 million retired people aged 55 or older relied on employer-sponsored health insurance as either their primary source of coverage or as a supplement to their Medicare coverage. Some of these persons are concerned about the continued availability of employer-sponsored coverage. Premium increases and forecasts for a potential economic slowdown could further erode employer-sponsore

Medicare provides valuable and extensive health care coverage for beneficiaries. Nevertheless, significant gaps leave some beneficiaries vulnerable to sizeable financial burdens from out-of-pocket expenses. Medigap is a widely available source of supplemental coverage. This testimony discusses (1) beneficiaries' potential financial liability under Medicare's current benefit structure and cost-sha

Much is at stake when it comes to Medicare reform--not only the program's future but also the nation's fiscal flexibility to pursue other important national goals and programs in the future. A comprehensive effort to reform Medicare and put it on a sustainable path would help fulfill this generation's stewardship responsibility to succeeding generations. It would also help to preserve some capaci

As Congress considers Medicare beneficiaries' access to prescription drug coverage, there is increased interest in the range of options available to help vulnerable populations obtain access to needed medications. Patient assistance programs, offered voluntarily by drug companies, are generally designed to provide prescription drugs to low-income persons who lack drug coverage. These programs typ

GAO noted that: (1) two states are enrolling a small number of dual eligibles in limited geographic areas into integrated care programs, and two additional states plan to implement programs by 2001; (2) officials in these four states view their initial efforts as stepping stones and plan to make their programs more widely available; (3) since the 1995 approval of an integrated care program in Min

GAO noted that: (1) estimates of the magnitude of the baby boomers' future long-term care needs vary, with estimates of the number of disabled elderly when the baby boom generation becomes elderly ranging from 2 to 4 times the current number; (2) estimates of cost are even more imprecise due to the uncertain effect of several important factors, including how many will be needing care, the types o

GAO noted that: (1) despite HCFA's efforts to pay claims correctly in its $167 billion fee-for-service Medicare program, several billions of dollars in Medicare overpayments occur each year; (2) it is therefore critical that HCFA undertake effective postpayment activities to identify overpayments expeditiously; (3) HCFA's claims administration contractors use several postpayment techniques to ide