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 Collection: Congressional Research Service Reports
Medicare Beneficiary Access to Care: The Effects of New Prospective Payment Systems on Outpatient Hospital Care, Home Health Care, and Skilled Nursing Facility Care
This report discusses the Balanced Budget Act of 1997 (BBA 97), which required that prospective payment systems replace retrospective cost-based reimbursement systems for Medicare beneficiaries receiving care in hospital outpatient departments, from home health care agencies, and in skilled nursing facilities. digital.library.unt.edu/ark:/67531/metacrs1047/
Medicare Home Health Benefit Primer: Benefit Basics and Issues
This report describes home health eligibility criteria, home health services, characteristics of Medicare beneficiaries who use home health services, and home health providers. Further, this report describes in detail the Medicare home health prospective payment system (HH PPS), provides an overview of Medicare home health payments, and discusses issues for Congress related to the Medicare home health benefit. digital.library.unt.edu/ark:/67531/metadc808302/
Older Displaced Workers in the Context of an Aging and Slowly Growing Population
This report analyzes the labor market experiences of those older workers who have involuntarily lost long-held jobs for reasons unrelated to their own performance (e.g., veteran factory workers at plants closed because of import competition, experienced information technology workers whose jobs have been outsourced to workers in other countries, and mid-level managers in positions eliminated through corporate restructuring). It examines current policies targeted at the reemployment of older displaced workers which, if successful, might lengthen their stay in the workforce. digital.library.unt.edu/ark:/67531/metadc821055/
Prescription Drug Coverage Under Medicaid
Medicaid is a joint federal-state entitlement program that pays for medical services on behalf of certain groups of low-income persons. It is the third largest social program in the federal budget, exceeded only by Social Security and Medicare and is typically the second largest spending item for states. This report discusses prescription drug policies under the program. digital.library.unt.edu/ark:/67531/metacrs7496/
Medicare Home Health Benefit Primer: Benefit Basics and Issues
This report describes home health eligibility criteria, home health services, characteristics of Medicare beneficiaries who use home health services, and home health providers. Further, this report describes in detail the Medicare home health prospective payment system (HH PPS), provides an overview of Medicare home health payments, and discusses issues for Congress related to the Medicare home health benefit. digital.library.unt.edu/ark:/67531/metadc820974/
Medicare Prescription Drug Proposals: Estimates of Aged Beneficiaries Who Fall Below Income Criteria, by State
This report discusses bills related to Medicare benefits, which include additional assistance for low-income beneficiaries. The assistance would have been in the form of reduced, subsidized or eliminated premiums, deductibles and other cost-sharing. Proposals in the 108th Congress will probably also include some of these features for low-income beneficiaries. digital.library.unt.edu/ark:/67531/metadc847645/
Older Americans Act: 106th Congress Legislation
This report provides brief legislative background for Older Americans Act programs expired at the end of FY1995. The report discusses issues with re-authorization and 106th Congress proposals. digital.library.unt.edu/ark:/67531/metadc821096/
Medicaid: Eligibility for the Aged and Disabled
No Description digital.library.unt.edu/ark:/67531/metacrs7023/
Older Americans Act Nutrition Program
No Description digital.library.unt.edu/ark:/67531/metacrs9201/
Beneficiary Information and Decision Supports for the Medicare-Endorsed Prescription Drug Discount Card
On December 8, 2003 the President signed into law the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA, P.L. 108-173). This legislation establishes a Medicare prescription drug benefit, effective January 1, 2006. In the interim, the legislation requires the Department of Health and Human Services (HHS) to establish a temporary program of Medicare-endorsed prescription drug discount cards. This report discusses the objectives and benefits of this legislation. digital.library.unt.edu/ark:/67531/metacrs6351/
The Pros and Cons of Allowing the Federal Government to Negotiate Prescription Drug Prices
No Description digital.library.unt.edu/ark:/67531/metacrs7743/
Medicare Endorsed Prescription Drug Discount Card Program
No Description digital.library.unt.edu/ark:/67531/metacrs6119/
President Bush's Proposed Medicare-Endorsed Drug Discount Card Initiative: Status and Issues
No Description digital.library.unt.edu/ark:/67531/metacrs4069/
Medicare: Major Prescription Drug Provisions of Selected Bills
No Description digital.library.unt.edu/ark:/67531/metacrs2332/
Medicare: Major Prescription Drug Provisions of Selected Bills
No Description digital.library.unt.edu/ark:/67531/metacrs2333/
Medicare: Major Prescription Drug Provisions of Selected Bills
No Description digital.library.unt.edu/ark:/67531/metacrs2334/
The Cost of Prescription Drugs for the Uninsured Elderly and Legislative Approaches
The purpose of this report is to explain why many of those who are least able to afford high drug costs are those who are most frequently charged the most. This report describes the basic economic theory underlying price differentiation and, in the context of the pharmaceutical market, analyzes the role and behavior of pharmacy benefit managers (PBMs), pharmaceutical manufacturers, and retail pharmacies, respectively. It also looks at a number of the criticisms that have been made of the practice of differential pricing. Finally, this report discusses various policy approaches aimed at assisting the elderly to purchase prescription drugs. digital.library.unt.edu/ark:/67531/metacrs1520/
President Bush's Proposed Medicare-Endorsed Drug Discount Card Initiative: Status and Issues
No Description digital.library.unt.edu/ark:/67531/metacrs2330/
President Bush's Proposed Medicare-Endorsed Drug Discount Card Initiative: Status and Issues
No Description digital.library.unt.edu/ark:/67531/metacrs2331/
Pharmacy Benefit Managers
No Description digital.library.unt.edu/ark:/67531/metacrs1268/
Civil Service Retirement Bills in the 106th Congress
Among the civil service retirement issues addressed in bills introduced thus far in the 106th Congress are the correction of retirement coverage errors for federal employees assigned to the wrong retirement system; immediate eligibility for federal employees to participate in the Thrift Savings Plan (TSP); improved portability of pension benefits; and repeal of the temporary increase in employee retirement contributions that was mandated by the Balanced Budget Act of 1997. Other bills would expand TSP eligibility to include members of the armed services; improve pension coverage for temporary and part-time federal employees; and designate several categories of federal employees as law enforcement officers for purposes of determining their retirement benefits. digital.library.unt.edu/ark:/67531/metacrs1241/
Social Security and Medicare Taxes and Premiums: Fact Sheet
No Description digital.library.unt.edu/ark:/67531/metacrs3367/
Social Security and Medicare Taxes and Premiums: Fact Sheet
No Description digital.library.unt.edu/ark:/67531/metacrs5302/
Income and Poverty Among Older Americans in 2007
This report describes the income and poverty status of the 36.8 million Americans age 65 and older who were living in households in 2007. The report also describes how the proportion of total income received from each source differs between high-income individuals and households and low-income individuals and households. digital.library.unt.edu/ark:/67531/metadc689291/
Factors Affecting the Demand for Long-Term Care Insurance: Issues for Congress
This report will discuss the role of long-term care insurance (LTCI) in financing long term care (LTC) costs and current trends in the LTCI industry; factors affecting the demand for LTCI, including cost and complexity of the product and adequacy of consumer protections; and key features of legislative proposals in the 111th Congress to address these issues. digital.library.unt.edu/ark:/67531/metadc689124/
Social Security and Medicare "Lock Boxes"
No Description digital.library.unt.edu/ark:/67531/metacrs1930/
Social Security and Medicare "Lock Boxes"
No Description digital.library.unt.edu/ark:/67531/metacrs1932/
Income and Poverty Among Older Americans in 2008
This report describes the sources and amounts of income received by the 37.8 million Americans aged 65 and older who lived in non-institutional settings in 2008. The report also describes how the proportion of total income received from each source differs between high-income individuals and households and low-income individuals and households. digital.library.unt.edu/ark:/67531/metadc689422/
Standardized Choices: Medigap Lessons for Medicare Part D
No Description digital.library.unt.edu/ark:/67531/metacrs9264/
Summary of the Medicare Regulatory and Contracting Reform Act of 2001 (H.R. 3391)
No Description digital.library.unt.edu/ark:/67531/metacrs1364/
Social Security: Raising the Retirement Age Background and Issues
The Social Security "full retirement age" will gradually rise from 65 to 67 beginning with people who attain age 62 in 2000 (i.e., those born in 1938). Early retirement benefits will still be available beginning at age 62, but at lower levels. To help solve Social Security's long-range financing problems, it has been proposed that these ages be raised further. digital.library.unt.edu/ark:/67531/metadc26050/
Medicare Provisions in the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA, P.L. 106-554)
No Description digital.library.unt.edu/ark:/67531/metacrs1363/
Medicare: Selected Prescription Drug Proposals
No Description digital.library.unt.edu/ark:/67531/metacrs1051/
Medicare: Side-by-Side Comparison of Selected Prescription Drug Bills
No Description digital.library.unt.edu/ark:/67531/metacrs1050/
Medicare Structure Reform: Background and Options
No Description digital.library.unt.edu/ark:/67531/metacrs1365/
Nursing Homes and the Congress: A Brief History of Developments and Issues
No Description digital.library.unt.edu/ark:/67531/metacrs8392/
Regulating Private Pensions: A Brief Summary of ERISA
This report briefly discusses the Employee Retirement Income Security Act of 1974 (ERISA), and how it protects the interests of participants and beneficiaries in private-sector employee benefit plans. ERISA covers a number of fringe benefits provided by employers, but most of its provisions deal with pension plans. Pension plans sponsored by the federal, state, and local governments, or by churches generally are exempt from ERISA. digital.library.unt.edu/ark:/67531/metadc29496/
Increases in Tricare Costs: Background and Options for Congress
In its FY2007, FY2008, and FY2009 budget submissions, the Department of Defense (DOD) proposed increases in Tricare enrollment fees, deductibles, and pharmacy co-payments for retired beneficiaries not yet eligible for Medicare. In passing the FY2009 National Defense Authorization Act, Congress included measures establishing demonstration projects intended to find ways to contain costs through increased use of preventive care services by TRICARE beneficiaries. The scope of these measures are limited. Defense health care spending will likely remain an issue for the DOD in the next Administration, and Congress can anticipate being asked to consider new proposals to constrain costs. digital.library.unt.edu/ark:/67531/metacrs10667/
Increases in Tricare Costs: Background and Options for Congress
In its FY2007, FY2008, and FY2009 budget submissions, the Department of Defense (DOD) proposed increases in Tricare enrollment fees, deductibles, and pharmacy co-payments for retired beneficiaries not yet eligible for Medicare. In passing the FY2009 National Defense Authorization Act, Congress included measures establishing demonstration projects intended to find ways to contain costs through increased use of preventive care services by TRICARE beneficiaries. The scope of these measures are limited. Defense health care spending will likely remain an issue for the DOD in the next Administration, and Congress can anticipate being asked to consider new proposals to constrain costs. digital.library.unt.edu/ark:/67531/metacrs10665/
Increases in Tricare Costs: Background and Options for Congress
In its FY2007, FY2008, and FY2009 budget submissions, the Department of Defense (DOD) proposed increases in Tricare enrollment fees, deductibles, and pharmacy co-payments for retired beneficiaries not yet eligible for Medicare. In passing the FY2009 National Defense Authorization Act, Congress included measures establishing demonstration projects intended to find ways to contain costs through increased use of preventive care services by TRICARE beneficiaries. The scope of these measures are limited. Defense health care spending will likely remain an issue for the DOD in the next Administration, and Congress can anticipate being asked to consider new proposals to constrain costs. digital.library.unt.edu/ark:/67531/metacrs10664/
Increases in Tricare Costs: Background and Options for Congress
This report discusses budgetary matters for the U.S. Department of Defense (DOD), specifically regarding past instances of debate regarding the Tricare system. The dollar amounts allocated to health care in the budget of the DOD have more than doubled since FY2001, growing from about $17 billion to over $44.8 billion in FY2009. digital.library.unt.edu/ark:/67531/metadc743367/
Medicare: Payments to HMOs and Other Private Plans Under the Medicare+Choice Program
This report describes how payments will be calculated under the Medicare+Choice program established under the new law. digital.library.unt.edu/ark:/67531/metacrs372/
Medicare: Prescription Drug Proposals
This report provides an overview of the President’s plan and the legislation introduced to date in the 106th Congress. It digital.library.unt.edu/ark:/67531/metacrs1048/
Medicare: Physician Payments
This report discusses payments for physicians services under Medicare that are made on the basis of a fee schedule. digital.library.unt.edu/ark:/67531/metacrs8886/
Medicare: Payments to Physicians
This report discusses payments for physicians services under Medicare that are made on the basis of a fee schedule. digital.library.unt.edu/ark:/67531/metacrs503/
Medicare: Beneficiary Cost-Sharing Under Proposed Prescription Drug Benefits
This report provides background on how the cost-sharing and premium provisions under each bill would affect the amount that a beneficiary pays annually for prescription drugs. In addition, this report gives examples of how annual cost-sharing would differ for beneficiaries with various levels of total prescription drug spending in 2006 under the plans. digital.library.unt.edu/ark:/67531/metacrs3700/
Medicare/Medicaid Reimbursement: Selected References
This report is a compilation of selected articles, books, and executive agency and congressional publications on Medicare and Medicaid reimbursement, primarily to health facilities and physicians. digital.library.unt.edu/ark:/67531/metacrs8868/
Medicare: Changes to Balanced Budget Act of 1997 (BBA 97, P.L. 105-33) Provisions
This report summarizes the major provisions of the agreement between the by House and Senate negotiators on the Medicare provisions. digital.library.unt.edu/ark:/67531/metacrs829/
Medicare+Choice Payments
This report discusses the M+C program that established new rules for beneficiary and plan participation. This report focuses on M+C payments. digital.library.unt.edu/ark:/67531/metacrs3697/
Medicare+Choice Payments
This report discusses the M+C program that established new rules for beneficiary and plan participation. This report focuses on M+C payments. digital.library.unt.edu/ark:/67531/metacrs2080/