Medicare Administrative Costs: Hearings Before the Subcommittee on Oversight of the Committee on Ways and Means, House of Representatives, Ninety-fourth Congress, Second Session, August 2 and 27, 1976U.S. Government Printing Office, 1976 - 239 pages |
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Page 13
... proposed for final reimbursement settlement . Of this amount , we recommended net downward financial adjust- ments of $ 16.4 million . Almost all of these reports either questioned costs or contained one or more recommendations for ...
... proposed for final reimbursement settlement . Of this amount , we recommended net downward financial adjust- ments of $ 16.4 million . Almost all of these reports either questioned costs or contained one or more recommendations for ...
Page 28
... proposals . I would like to briefly describe these processes . Contractors are required to file budget requests with the Bureau of Health Insurance on April 15th each year for the forthcom- ing government fiscal year . These requests ...
... proposals . I would like to briefly describe these processes . Contractors are required to file budget requests with the Bureau of Health Insurance on April 15th each year for the forthcom- ing government fiscal year . These requests ...
Page 29
... proposal with the full explanation of all costs incurred . This report is audited by the HEW Audit Agency in ... proposals which the contractors already believed were reasonable . Through negotiated final cost settlement during fiscal ...
... proposal with the full explanation of all costs incurred . This report is audited by the HEW Audit Agency in ... proposals which the contractors already believed were reasonable . Through negotiated final cost settlement during fiscal ...
Page 40
... proposed merger of the two organizations and a combined customer service department would solve that problem , Suycott , said . " " Unlike Blue Shield , Blue Cross doesn't have hospitals harassing patients or getting after them all the ...
... proposed merger of the two organizations and a combined customer service department would solve that problem , Suycott , said . " " Unlike Blue Shield , Blue Cross doesn't have hospitals harassing patients or getting after them all the ...
Page 41
... proposals . But even a top Blue Cross official admits that figure might not be totally accurate . Nevertheless , the ... proposed rate increases until the day of the meeting . Since the committee members can face up to 30 rate requests ...
... proposals . But even a top Blue Cross official admits that figure might not be totally accurate . Nevertheless , the ... proposed rate increases until the day of the meeting . Since the committee members can face up to 30 rate requests ...
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Common terms and phrases
accounting activities administrative costs agreement allocation amount Article Audit Agency BCA's benefits bill Blue Cross Association Blue Cross plans Blue Cross-Blue Shield Blue Shield budget Bureau of Health carriers changes charge claims processing committee CONGRESS THE LIBRARY contract contractors cost accounting standards cost reports data processing determined developed effective executive executive compensation expenses Federal Health Insurance Federal Procurement Regulations fiscal funds Government HEW Audit hospital increase incurred instructions Intermediary issues letter of credit LIBRARY OF CONGRESS Medicaid Medicare program million negotiation operations organizations panel paragraph payment percent performance physicians prior approval private sector problems procedures Professor LAW proposed providers of services question RANGEL rate review record reimbursement responsibility role salaries Secretary Social Security Administration specific staff STARK STEPNICK subcontract submit Suycott tape-to-tape TIERNEY tion TRESNOWSKI utilization review vice president Wisconsin
Popular passages
Page 220 - Contractor shall proceed diligently with the performance of the contract and in accordance with the Contracting Officer's decision. (b) This "Disputes" clause does not preclude consideration of law questions in connection with decisions provided for in paragraph (a) above : Provided, That nothing in this contract shall be construed as making final the decision of any administrative official, representative, or board on a question of law.
Page 196 - Defense to procure supplies and services from responsible sources at fair and reasonable prices calculated to result in the lowest ultimate overall cost to the Government.
Page 194 - The decision of the Secretary or his duly authorized representative for the determination of such appeals shall be final and conclusive unless determined by a court of competent Jurisdiction to have been fraudulent, or capricious, or arbitrary, or so grossly erroneous as necessarily to imply bad faith, or not supported by substantial evidence.
Page 199 - Disputes" clause of this contract, (2) litigation or the settlement of claims arising out of the performance of this contract, or (3) costs and expenses of this contract as to which exception has been taken by the Comptroller General or any of his duly authorized representatives, shall continue until such appeals, litigation, claims, or exceptions have been disposed of.
Page 168 - No disbursing officer shall, in the absence of gross negligence or intent to defraud the United States, be liable with respect to any payment by him under this...
Page 180 - Except as otherwise provided in this contract, any dispute concerning a question of fact arising under this contract which is not disposed of by agreement shall be decided by the Contracting Officer, who shall reduce his decision to writing and mail or otherwise furnish a copy thereof to the Contractor.
Page 202 - Contractor, was then of said Corporation; that said Contract was duly signed for and in behalf of said Corporation by authority of its governing body, and is within the scope of its corporate powers.
Page 168 - No certifying or disbursing officer shall be held liable for any amount certified or paid by him in good faith to any person where the recovery of such amount is waived under subsection (c) of this section or has been begun but cannot be completed under subsection (a) of this section.
Page 183 - I know his signature, and his signature thereto is genuine; and that said bond was duly signed, sealed, and attested for and in behalf of said corporation by authority of its governing body. ["Corporate"!
Page 134 - ... by providers of services and other persons to individuals entitled to benefits under this part, and provide procedures for and assist in arranging, where necessary, the establishment of groups outside hospitals (meeting the requirements of section...