Federal funding for state surveys increased from fiscal years 2000 through 2002 but was nearly flat from fiscal years 2002 through 2007. In inflation-adjusted terms, funding fell 9 percent from fiscal years 2002 through 2007. CMS has made incremental adjustments to improve its management of state allocations. It shifted federal funding from support contracts to surveys, increasing state allocatio

IRS's community benefit standard allows nonprofit hospitals broad latitude to determine the services and activities that constitute community benefit. Furthermore, state community benefit requirements that hospitals must meet in order to qualify for state tax-exempt or nonprofit status vary substantially in scope and detail. For example, 15 states have community benefit requirements in statutes o

Long-term fiscal simulations by GAO, the Congressional Budget Office (CBO), and others all show that despite a decline in the federal government's unified budget deficit between fiscal years 2003 and 2007, it still faces large and growing structural deficits driven primarily by rising health care costs and known demographic trends. Simply put, the federal government is on an unsustainable long-te

GAO has reported for more than a decade on varied financing arrangements that inappropriately increase federal Medicaid matching payments. In reports issued from 1994 through 2005, GAO found that some states had received federal matching funds by paying certain government providers, such as county-operated nursing homes, amounts that greatly exceeded established Medicaid rates. States would then

SCHIP program structures for adults in the 10 states varied, particularly in terms of the categories of adults covered--whether they were parents or childless adults--and the types of coverage offered. For fiscal year 2007, 5 of the 10 states (Arizona, Minnesota, New Jersey, Rhode Island, and Wisconsin) covered parents only, 1 state (Michigan) covered childless adults only, and 4 states (Idaho, I

Over 30,000 Medicaid providers, about 5 percent of those paid in fiscal year 2006, had over $1 billion of unpaid federal taxes. These 30,000 providers were identified from a nonrepresentative selection of providers from seven states: California, Colorado, Florida, Maryland, New York, Pennsylvania, and Texas. This $1 billion estimate is likely understated because some Medicaid providers have under

Nursing homes that participate in Medicare and Medicaid must periodically assess the needs of residents in order to develop an appropriate plan of care. Such resident assessments are known as the minimum data set (MDS). According to officials in the 10 states with MDS accuracy review programs in operation as of January 2001, these programs were established to set Medicaid payments and identify qu

Some states have taken advantage of the flexibility that Congress built into the Medicaid program by devising schemes that inappropriately boost the federal share of program expenditures. These schemes were adding billions of dollars a year to federal Medicaid costs without the states paying their statutorily specified share of program costs. Moreover, some of the federal funds were being spent f

This report, part of GAO's performance and accountability series, discusses the major management challenges and program risks facing the Department of Health and Human Services (HHS). HHS must improve its administration of the Medicare Program to ensure that it remains fiscally sustainable. GAO found that HHS must address several issues, including frequent changes in leadership and recruitment of

GAO noted that: (1) overall, the series of federal quality initiatives begun 2 years ago has produced a range of nursing home oversight activities that need continued federal and state commitment to reach their full potential; (2) certain of the federal initiatives seek to strengthen the rigor with which states conduct their required annual surveys of nursing homes; (3) others focus on the timeli