Reports & Testimonies

As part of FY23 appropriations, Members of Congress could request to designate a certain amount of federal funding for specific projects in their communities. While agencies often have discretion over how they award funds, Congress has directed them to distribute these funds to designated recipients. We're tracking these funds to help ensure transparency. The Office of National Drug Control Policy's FY23 appropriations included nearly $10.5...

Scientists have predicted that another pandemic is likely. They've identified the viruses that might cause it—although the Department of Health and Human Services told us that few antiviral drugs for those viruses have been approved or are in HHS-funded clinical trials. Our panel of experts suggested several ways for policymakers to incentivize the development of these antiviral drugs, such as research grants or commitments to...

Millions of people around the world have died from COVID-19 . The U.S. government has pledged to help reach a goal to vaccinate 70% of the global population against the virus. In support of this goal, the U.S. Agency for International Development worked with global and local partners to help 125 countries vaccinate their populations against COVID-19. But issues like falling demand for the vaccine...

Private equity firms have drawn attention in recent years by buying nursing homes, changing their operations to increase profit, and selling them for more money. We estimated that 5% of about 14,800 nursing homes enrolled in Medicare had private equity owners in 2022. Medicare collects information about nursing home owners as part of its enrollment and oversight processes. But we had to supplement Medicare's data...

The Provider Relief Fund spent $135 billion to help health care providers with COVID -related expenses and lost revenue during the pandemic. Most of the relief payments—about $85 billion—went to hospital-based health systems and hospital-affiliated providers. To confirm that payments were accurate, the Health Resources and Services Administration took steps to review provider eligibility and if funds were used appropriately. In doing so, it found...

States and the federal government work together to fund Medicaid and protect it from payment errors and fraud. State auditors provide independent reviews of their state's compliance with federal funding requirements and other program rules. Their findings reveal problems such as ineligible beneficiaries and errors in state spending. Federal Medicaid officials started using these findings and collaborating with state auditors to improve the program, but...

This testimony discusses the key role of Medicare Part D drug coverage in giving beneficiaries access to innovative drug treatments. Coverage is provided by private insurance plans that vary in their costs and lists of covered drugs—known as "formularies." Drug makers may give plans rebates in exchange for preferred placement over competitors on formularies. The rebates may lower premiums, but they don't reduce beneficiaries' payments...

Four Health and Human Services agencies had key roles in the federal COVID-19 response. Our prior reports noted shortcomings to that response, including possible political interference. Our panel of government, academic, and non-profit experts identified steps agencies can take to protect against such interference: Set agency policies to prohibit interference and allow transparency in addressing allegations Train agency staff on how to implement policies Use...

There are many TV, print, and online ads for medical devices, such as blood pressure monitors or contact lenses. Direct-to-consumer ads can educate people about devices that may help them. But some of the ads can raise concerns for consumers, doctors, and patients, such as: False advertising Ads that create high demand for a product, which can lead to higher costs Ads that target vulnerable...

Medicare beneficiaries can have prescription drugs covered via private insurance plans participating in the Medicare Part D program. Premiums and drug costs vary by plan, as do plans' lists of covered drugs—known as "formularies." Drug makers may give plans rebates in exchange for preferred placement over competitors on formularies. The rebates may lower plan premiums, but they don't reduce beneficiaries' payments for the drugs. We...

The Department of Labor's Job Corps is the nation's largest residential, educational, career and technical training program for low-income youth. Illegal drugs are not allowed at Job Corps' centers, and students must be tested for drug use when they arrive. Students testing positive must receive drug intervention services—to help them understand their substance use and how to abstain from it—and be retested. Students who test...

In 2016, Congress directed the Defense Health Agency to run military medical facilities. As part of the multiyear transition of these facilities to DHA oversight, the agency set up 22 offices to manage facilities that it grouped into 36 U.S. "markets" and 2 overseas regions. But staffing the offices has been hard. DHA estimated it needs over 1,400 personnel to do so—which exceeds expected resources...

Many children affected by trauma receive services through more than one system, such as child welfare and health care. Communities need to develop and coordinate programs, policies, and practices to ensure that children receive services that address trauma-related needs and actively avoid re-traumatizing them. To help communities, one initiative lets multiple federal agencies combine their funding to create partnership programs for grant recipients serving children...

We examined the Department of Health and Human Services' funding options to help address immediate needs of a public health emergency or threat. HHS has used a fund designated for infectious disease emergencies and threats like COVID-19 and Ebola. The fund can't be used for other types of health threats that arise, for example, from floods. HHS has another fund for any kind of public...

Alternatives to traditional health insurance may advertise lower up-front costs or more flexibility. But they also don't have to adhere to federal consumer protection requirements—like guaranteed coverage for pre-existing conditions or mental health services. We provide information on 3 types of health coverage alternatives: Health plans sold to members of state Farm Bureaus—i.e., agriculture advocacy groups "Health care sharing ministries"—groups organized around beliefs or ethics...

Service members who have experienced unwanted sexual behavior, such as harassment or assault, may suffer from chronic mental health problems. These service members can get non-medical counseling through the Department of Veterans Affairs. But longer-term and psychiatric care are only available with a referral that would be shared with the Department of Defense as part of their patient record—which may deter some service members from...

In July 2020, we reported that the CARES Act gave the Food and Drug Administration new tools to regulate over-the-counter drugs like sunscreen and cold medicine. It included a provision offering 18 months of exclusive marketing rights for drugs with new uses or innovative active ingredients. As of May 2023, however, no companies had requested approval for over-the-counter drug innovations. FDA is still preparing to...

VA's Office of the Medical Inspector investigates concerns about the quality of health care that the VA provides to veterans, such as reports of understaffing or improper patient scheduling practices in VA facilities. Most of the cases result in recommendations. But the office relies on one staff person to decide if recommendations have been met—which means it could close recommendations without knowing if the VA...

Regenerative medicine restores or replaces human cells, tissues, or organs affected by disease. This may eventually help cure many conditions that are currently considered difficult to treat. For example, a patient's own cells could be used to create a personalized organ, which could eliminate the possibility that a patient's body will reject a donated organ. However, there are challenges with developing regenerative medicine technologies. We...

The Department of Defense has about 108,000 active duty medical personnel who provide health care on the battlefield and in military hospitals and clinics across the nation. In 2021, DOD proposed reducing the number of military medical personnel by over 10,000. These reductions could make it harder for the military health system to provide quality care and could affect the cost of that care. But...