GAO’s reports and testimonies give Congress, federal agencies, and the public timely, fact-based, non-partisan information that can improve government operations and save taxpayers billions of dollars.
States must screen and enroll health care providers in Medicaid according to federal and state rules. These rules are designed to exclude providers who don’t meet minimum standards, which can help prevent fraud, waste, and abuse.
What GAO Found Overall spending for high-expenditure disabled dual-eligible beneficiaries—those in the top 20 percent of spending in their respective states—was driven largely by Medicaid spending, and the service use and health status often differed widely between those with high Medicare expenditures...
What GAO FoundThirteen states reported that in fiscal year 2012 they paid a total of about $5.6 billion to limited benefit plans to provide mental health services to about 4.4 million adult Medicaid beneficiaries.
What GAO FoundWhy GAO Did This StudyThe Centers for Medicare & Medicaid Services (CMS)--an agency within the U.S. Department of Health and Human Services (HHS)--is responsible for overseeing Medicare, Medicaid, and the State Children's Health Insurance Program.
What GAO Found Agencies did not publish a notice of proposed rulemaking (NPRM), enabling the public to comment on a proposed rule, for about 35 percent of major rules and about 44 percent of nonmajor rules published during 2003 through 2010.
What GAO FoundThe QI program enrolled about 426,000 individuals nationwide in 2009--the most recent year for which comprehensive enrollment data were available--with expenditures of about $431 million.
What GAO FoundThe five studies GAO reviewed that used microsimulation models to estimate the effects of the Patient Protection and Affordable Care Act (PPACA) on employer-sponsored coverage generally predicted little change in prevalence in the near term, while results of employer surveys varied more...