The key challenge faced by the Medicaid Integrity Group (MIG) is the need to avoid duplication of federal and state program integrity efforts, particularly in the area of auditing provider claims. In 2011, the MIG reported that it was redesigning its national provider audit program. Previously, its audit contractors were using incomplete claims data to identify overpayments. According to MIG data

We found that for most of the drugs in our sample, using AMP and other data from 2008, FULs based on PPACA's formula were lower than pre-PPACA FULs and higher than average retail pharmacy acquisition costs. Specifically, the FULs based on PPACA's formula were lower than pre-PPACA FULs for 36 of the 40 drugs in our sample. For 34 out of the 40 drugs, the FULs based on PPACA's formula were higher t

States and CMS have made concerted efforts to improve access to dental services for children in Medicaid. However, information on the oral health of and receipt of dental services by Medicaid children show that more needs to be done. Although many states have reported moderate increases in access to Medicaid dental services, states responding to our survey reported that low provider and beneficia

Rapidly rising health care costs are not simply a federal budget problem. Growth in health-related spending also drives the fiscal challenges facing state and local governments. The magnitude of these challenges presents long-term sustainability challenges for all levels of government. The current financial sector turmoil and broader economic conditions add to fiscal and budgetary challenges for

CMS and IHS have interacted to (1) provide support to IHS-funded facilities and tribes in their access to Medicare and Medicaid and (2) address broader policy and regulatory concerns regarding these programs. Their interactions to provide support have included education and technical assistance; the agencies also have interacted to obtain input from tribal representatives on program operations. O

This is an E-Supplement to GAO-08-346, which was released on May 13, 2008. This product lists the questions asked and the summary results from three GAO surveys of state child welfare or protective service, health and mental health, and juvenile justice and rehabilitation agency directors. The Web-based surveys asked questions about the extent to which state agencies licensed and monitored reside

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

VA estimates that about 196,000 veterans nationwide were homeless on a given night in 2006, based on its annual survey, and that the number of transitional beds available through VA and other organizations was not sufficient to meet the needs of eligible veterans. The GPD program has quadrupled its capacity to provide transitional housing for homeless veterans since 2000, and additional growth is

SCHIP enrollment increased rapidly during the program's early years but has stabilized over the past several years. As of fiscal year 2005, the latest year for which data are available, SCHIP covered approximately 6 million enrollees, including about 639,000 adults, with about 4 million enrollees in June of that year. Many states adopted innovative outreach strategies and simplified and streamlin

Molluscan shellfish--oysters, clams, mussels, and scallops--cause more than 100,000 illnesses annually, according to the most recent available estimates made by the Food and Drug Administration (FDA). Unlike meat and most other seafood products, which are normally cooked before consumption, shellfish are often eaten raw, increasing the risk of illness. The severity of illnesses that occur from co