Medicare: Further Changes Needed to Reduce Program and Beneficiary Costs : Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of RepresentativesThe Office, 1991 - 86 pages |
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1986 Through March administrative Affecting the Medicare ambulatory surgery anesthesia services Anesthesiologists Annotation of GAO assessed Beneficiary Costs ciaries Congress DRGs Effects enrolled enrollees evaluation expenditures federal fee schedule fiscal year 1990 funding Further Changes Needed GAO Products Relating HCFA HCFA's Health Insurance Health Maintenance Organization home health hospital outpatient House Committee implementation incentives increased Issues Affecting June legislative March 1991 Medicare Medicaid Medical Malpractice Medicare and Medicaid Medicare beneficiaries Medicare claims Medicare payments Medicare pays Medicare Program Medicare's Medigap Insurance ment million monitoring Needed to Reduce out-of-pocket costs patients payer payment safeguard percent physi physician payment physician services potential PPS payments Program and Beneficiary prospective payment system Published From January quality assurance Reduce Program Relating to Issues requirements risk of closure rural hospitals safeguard activities Sept Subcommittee on Health teaching hospitals Testimony treatment costs Uninsured
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Page 69 - GAD report on contractors' performance in fiscal years 1983-87 includes data relating to ( 1) Medicare claims processing times and accuracy; (2) review of appealed claims cases; (3) processing of hearings related to appealed claims; (4) written, telephone, and walk-in inquiries by beneficiaries and providers; and (5) education of beneficiaries and providers about Medicare coverage and requirements. Medicaid: Improvements Needed in Programs to Prevent Abuse (GAO/HRIWI7.75, Sept. 1087). GAO evaluated...
Page 52 - Before the Subcommittee on Health and the Environment House Committee on Energy and Commerce May 31, 1989 Thank you, Mr.
Page 72 - Aug. 1990). GAO reviewed and assessed the Health Resources and Services Administration's development of the National Practitioner Data Bank. Medicare: IKTA Can Reduce Paperwork Burden for Physicians and Their Patients (CAO/HKMME, June 1990).
Page 73 - Feb. 1990). GAO addressed the following four elements viewed essential to a comprehensive national strategy: (1) national practice guidelines and standards of care; (2) enhanced data to support quality assurance activities; (3) improved approaches to quality assessment and assurance at the local level; and (4) a national focus for developing, implementing, and monitoring a national system. Laboratory Accreditation: Requirements Vary Throughout the Federal Government (GAO/RCED-89-102, Mar.
Page 43 - Medicare: More Hospital Costs Should Be Paid by Other Insurers (GAO/HRD-87-43, Jan. 29, 1987). Medicare: Incentives Needed to Assure Private Insurers Pay Before Medicare (GAO/HRD-8919, Nov. 29, 1988) All of these approaches attempt to identify the possibility of private insurance coverage-^-but only at one point in time. Because beneficiaries' employment status is fluid, information collected through these efforts can become obsolete.
Page 1 - ... by title XVIII of the Social Security Act, helps pay medical costs for people age 65 years and older and certain individuals with disabilities. Medicare is administered by the Health Care Financing Administration (HCFA), within the Department of Health and Human Services. Medicare costs represent the fourth largest category of federal expenditures after defense, social security, and interest payments on the national debt. HCA is a large hospital management company headquartered in Nashville,...
Page 73 - ... national strategy: (1) national practice guidelines and standards of care; (2) enhanced data to support quality assurance activities; (3) improved approaches to quality assessment and assurance at the local level; and (4) a national focus for developing, implementing, and monitoring a national system. Laboratory Accreditation: Requirements Vary Throughout the Federal Government (GAO/RCED-89-102, Mar. 1989). GAO examined laboratory accreditation requirements of the various federal government programs...
Page 60 - June 8, 1989). Testimony before the Subcommittee on Health and the Environment, Committee on Energy and Commerce, House of Representatives. GAO provided information on the patterns of physician referrals to clinical diagnostic laboratories and diagnostic imaging centers in Pennsylvania and Maryland. The analysis examined (1) the extent of physician ownership of the two types of facilities, (2) whether physician ownership measurably influenced utilization rates for referral services, and (3) the terms...
Page 73 - Mar. 1989). This report evaluated HHS'S Office of Inspector General policy and procedures for responding to peer review organizations' recommendations for monetary penalties against hospitals and physicians who have delivered improper or unnecessary care. Internal Controls: Need to Strengthen Controls Over Payments by Medicare Intermediaries (GAO/HRD-89-8, Nov.
Page 72 - Abu»e, 1986-91 Medicare and Medicaid: More Information Exchange Could Improve Detection of Substandard Care (GAO/HRD-90-29, Mar. 1990). GAO determined (1) whether peer review organizations, Medicare carriers, and state Medicaid agencies reviewed services provided by the same physicians, (2) whether these review entities regularly exchanged information on such physicians who were found to provide unnecessary or poor-quality care, and (3) whether legal restrictions on such exchanges existed. Quality...