This is an E-supplement to GAO-12-821. This e-supplement presents the questions and aggregate results from a Web survey of state budget directors on the fiscal implications of Medicaid expansion implementation on state budget planning...

The Department of Defense's (DOD) plans to increase the U.S. military presence on Guam are expected to increase the island's current military population by about two and a half times by 2020. If implemented as planned, this realignment would increase the military population on Guam from about 15,000 in 2009 to about 29,000 in 2014, and to more than 39,000 by 2020, which will increase the current i...

Congress, policy analysts, and groups representing physicians have periodically raised concerns that Medicare's efforts to control spending on physician services by limiting annual updates to physician fees could have an adverse impact on beneficiaries' access to physician services. These concerns were heightened in 2002 when Medicare's formula for setting physician fees required a 5.4 percent red...

Migration from the Federated States of Micronesia, the Republic of the Marshall Islands, and Palau has had a significant impact on Guam, Hawaii, and the Commonwealth of the Northern Mariana Islands (CNMI). The health and education needs of these migrants have particularly affected the budgetary resources of Guam and the CNMI. The budgetary impact on Hawaii is smaller but is expected to grow as Haw...

Pursuant to a congressional request, GAO reviewed the need for establishing a Department of Veterans Affairs (VA) inpatient facility on Guam, focusing on: (1) how VA currently meets Guam and the Commonwealth of the Northern Mariana Islands (CNMI) veterans' health care needs; (2) veterans' possible future demand for health care and VA's ability to meet this demand; and (3) the cost to establish a v...

Pursuant to a congressional request, GAO examined: (1) what elements are considered important to a system for processing health maintenance organization (HMO) member complaints and appeals; (2) the extent to which HMOs' complaint and appeal system contain these elements; (3) what concerns consumers have regarding HMO complaint and appeal systems; (4) what information is available on the number and...

Pursuant to a congressional request, GAO provided information on the: (1) number of Medicare beneficiaries enrolling in health maintenance organizations (HMO); and (2) factors that influence beneficiaries' decisions to enroll in HMO.GAO found that: (1) about 2.8 million Medicare beneficiaries are enrolled in risk-contract HMO and another 2 percent are enrolled in cost-reimbursement HMO; (2) the nu...

Pursuant to a congressional request, GAO determined whether regional carrier coverage criteria for durable medical equipment and supplies is consistent with Medicare law, focusing on: (1) the national Medicare requirements and the regional carriers' coverage criteria; and (2) how the criteria have been applied to claims.GAO found that: (1) the final criteria adopted by the regional carriers are co...

Pursuant to a congressional request, GAO reviewed benefit payments by Medigap policies between 1988 and 1994, focusing on trends in Medigap insurers' aggregate loss ratio performance.GAO found that: (1) the Medigap market grew from $7.3 billion to $12.1 billion between 1988 and 1993; (2) Medigap insurers' aggregate loss ratios were stable from 1988 to 1991, but these ratios decreased about 10 perc...

Pursuant to a congressional request, GAO examined the medical capabilities and medical referral problems in American Samoa, the Commonwealth of the Northern Mariana Islands, the Republics of Palau and the Marshall Islands, and the Federated States of Micronesia.During the last 3 years, the local governments in the territories reviewed have incurred costs of about $15 million for referring patients...