Congressional Research Service Reports - 329 Matching Results
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- Medicare Advantage (MA)--Proposed Benchmark Update and Other Adjustments for CY2016: In Brief
- This report provides a brief background on how Medicare Advantage (Part C or MA) payments are determined through a comparison of a plan's estimated cost (bid) and the maximum amount Medicare will pay a plan (benchmark).
- Ergonomics in the Workplace: Is It Time for an OSHA Standard?
- This report debates implementing an OSHA (Occupational Safety and Health Administration) standard for ergonomics. This standard would be motivated by the fact that one third of state employer's costs are related to improper ergonomic design causing illness. The report details that standards suggested in the past have been rejected by Congress.
- NFIB v. Sebelius: Constitutionality of the Individual Mandate
- Report that provides an overview of the Court's holding with respect to the individual mandate of the Patient Protection and Affordable Care Act (ACA) under the Commerce Clause and the Taxing Power. It also addresses possible implications of the decision on existing federal law and future legislation.
- Medicare Trigger
- This report analyzes the financing of Medicare and its impact on the federal budget. It includes a discussion of the Medicare "trigger," which requires certain actions to be taken should general revenue funding be expected to exceed a certain proportion of total Medicare outlays within a certain number of years.
- Medicare: Enrollment in Medicare Drug Plans
- This report discusses the enrollment process for private prescription drug plans (PDPs) or Medicare Advantage prescription drug (MA-PD) plans. At a minimum, these plans offer "standard coverage" or alternative coverage with actuarially equivalent benefits. Beneficiaries are required to enroll in one of these private plans in order to obtain coverage.
- Medicaid Citizenship Documentation
- Due to recent changes in federal law, individuals who declare that they are citizens for Medicaid eligibility purposes must present documentation that proves citizenship and documents personal identity. This report discusses issues related to Medicaid citizenship documentation that have received considerable media and interest group attention, as well as proposed legislation that would affect the requirement.
- The ACA Medicaid Expansion
- This report provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the report describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrollment and expenditure estimates for the ACA Medicaid expansion are provided. Finally, the report reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.
- Medicaid Issues for the 109th Congress
- Medicaid is jointly financed by the federal and state governments, but each state designs and administers its own state program under broad federal guidelines. Accordingly, state variation in eligibility, covered services, and the delivery of, and reimbursement for, services is the rule rather than the exception. How is Congress to respond to the numerous proposals to move Medicaid forward into the near and long term? This report lays out some of these issues, explains the factors underlying them, and provides links to CRS products that can help Members of Congress and their staff prepare to discuss Medicaid’s role today and into the future.
- Medicare: FY2007 Budget Issues
- This report discusses President's budget request to Congress for Medicare, for the following federal fiscal year, along with projections for the five-year budget window. The President’s 2007 budget includes Medicare legislative proposals for Part A (Hospital Insurance) and Part B (Supplementary Medical Insurance) spending with estimated savings of $2.5 billion in 2007 and $35.9 billion over the five-year budget window.
- Medicare Primer
- This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.
- Medicare: Enrollment in Medicare Drug Plans
- This report discusses the enrollment process for private prescription drug plans (PDPs) or Medicare Advantage prescription drug (MA-PD) plans. At a minimum, these plans offer "standard coverage" or alternative coverage with actuarially equivalent benefits. Beneficiaries are required to enroll in one of these private plans in order to obtain coverage.
- The Independent Payment Advisory Board
- This report, which provides an overview of the Payment Advisory Board, begins with a discussion of the rationale behind the creation of an independent Medicare board and briefly reviews prior proposals for similar boards and commissions. The report then describes the structure of the Board, the calculations and determinations required to be made by the Office of the Chief Actuary (the Chief Actuary) in the Centers for Medicare & Medicaid Services (CMS) that trigger a Board proposal, and the content of and constraints on Board proposals--including the Medicare productivity exemptions under Section 3401 of the The Patient Protection and Affordable Care Act (PPACA).
- Medicare Structural Reform: Background and Options
- THis report provides a brief overview of major issues underlying the debate about possible structural reforms or improvements to the current Medicare system. Medicare is a nationwide health insurance program for the aged and certain disabled persons.
- Medicare: FY2008 Budget Issues
- This report discusses President's budget request to Congress for Medicare, for the following federal fiscal year, along with projections for the five-year budget window. The President’s 2008 budget includes Medicare legislative proposals with estimated savings of $4.3 billion in 2008 and $65.6 billion over the five-year budget window.
- Medicaid: A Primer
- This report describes the basic elements of Medicaid, focusing on federal rules governing who is eligible, what services are covered, how the program is financed and how beneficiaries share in the cost, how providers are paid, and the role of special waivers in expanding eligibility and modifying benefits. The recently passed Deficit Reduction Act of 2005 or DRA, as amended by the Tax Relief and Health Care Act of 2006, included many provisions affecting Medicaid. DRA provides states with opportunities to make fundamental changes in Medicaid program design, including covered benefits and beneficiary cost-sharing. These and other major DRA changes are summarized here. Lastly, basic program statistics and citations to in-depth CRS reports on specific topics are provided.
- Key Facts on Alcohol and Alcoholism
- This report provides statistics and facts about the drinking of alcohol and alcoholism.
- Health Legislation Confronting the 92nd Congress
- This report provides an overview of health related legislation and proposals which are likely to be debated in the 92nd Congress.
- The Independent Payment Advisory Board
- In response, in part, to overall growth in Medicare program expenditures and growth in expenditures per Medicare beneficiary, the Patient Protection and Affordable Care Act created the Independent Payment Advisory Board (IPAB, or the Board) and charged the Board with developing proposals to "reduce the per capita rate of growth in Medicare spending." This report discusses the responsibilities and duties.
- Medicare Advantage
- This report is an overview of the Medicare Advantage (MA) program, an alternative way for Medicare beneficiaries to receive covered benefits, and includes legislative history and analysis of recent trends.
- The Independent Payment Advisory Board (IPAB): Frequently Asked Questions
- This report responds to frequently asked questions about the Independent Payment Advisory Board (IPAB), including the board's background, current status, controversial issues including legal challenges, and recent legislative efforts to repeal the IPAB.
- Health Insurance: Small is the New Large
- This report discusses aspects of the Patient Protection and Affordable Care Act that expand the definition of small employer to include employers with 100 or fewer employees. States must implement the expanded definition for plan years beginning in 2016, but have the option of implementing the expanded definition prior to the deadline.
- Medicare: Private Contracts
- This report discusses private contracting for medicare,which is the term used to describe situations where a physician and a patient agree not to submit a claim for a service which would otherwise be covered and paid for by Medicare.
- Medicaid Issues for the 109th Congress
- This report provides background information for medicaid reforms and discuses proposals for reform.
- Medicaid: A Primer
- This report describes the basic elements of Medicaid, focusing on federal rules governing who is eligible, what services are covered, how the program is financed and how beneficiaries share in the cost, how providers are paid, and the role of special waivers in expanding eligibility and modifying benefits.
- Medicare Financing
- This report provides an overview of how the Medicare program is financed, including a description of the Medicare trust funds and a summary of key findings and estimates from the 2013 Report of the Medicare Board of Trustees regarding 2012 program operations and future financial soundness.
- Military Medical Care: Frequently Asked Questions
- This report answers selected frequently-asked questions about military health care, including: 1) How is the Military Health System structured?, 2) What is TRICARE?, 3) What are the different TRICARE plans and who is eligible?, 4) What are the costs of military health care to beneficiaries?, 5) What is the relationship of TRICARE to Medicare?, 6) How does the Affordable Care Act affect TRICARE?, 7) When can beneficiaries change their TRICARE plan?, and 8) What is the Medicare Eligible Retiree Health Care fund, which funds TRICARE for Life?
- Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System
- This report provides a background on the Medicare fee schedule, the Sustainable Growth Rate (SGR) system and the annual updates, and discusses recent proposal to address this issue.
- Medicare Primer
- This report provides an overview of Medicare, the nation's federal insurance program, which pays for covered health care services of qualified beneficiaries.
- Overview of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003
- This report examines the the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which creates a prescription drug benefit for Medicare beneficiaries and establishes a new Medicare Advantage program to replace the current Medicare+Choice program.
- Bipartisan Budget Act of 2018 (P.L. 115-23): Brief Summary of Division E-The Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act
- This report provides a brief summary of each of the provisions included in Division E (the ACCESS Act) of the Bipartisan Budget Act of 2018, along with the contact information for the CRS expert who can answer questions about each provision. Division E consists of 12 titles. Each title is addressed in a separate table, and the provisions are discussed in the order they appear in the law. Topics discussed in this report include Medicare, Medicaid, the State Children's Health Insurance Program (CHIP), public health, child and family services, foster care, social impact partnerships, child support enforcement, and prison data reporting. Subsequent CRS reports examining selected subsets of these provisions will be linked to this report as they become available.
- The Individual Mandate for Health Insurance Coverage: In Brief
- This report provides an overview of the individual mandate for health insurance, its associated penalty, and the exemptions from the mandate.
- Tax Options for Financing Health Care Reform
- This report reviews the revenue raisers proposed to fund health care reform. Other financing proposals are presented including those made by the Obama Administration and those introduced in earlier congressional work. The final sections discuss other proposals suggested by the round-table discussion participants.
- The Community Health Center Fund: In Brief
- This report provides information on the Community Health Center Fund (CHCF) that may be useful for discussions about the fund's future. Specifically, it includes information on: the types of grants awarded, total funds disbursed, and the amount of CHCF funds that facilities in each state and territory received.
- Appropriations and Fund Transfers in the Affordable Care Act (ACA)
- This report summarizes all the mandatory appropriations and Medicare trust fund transfers in the ACA and provides details on the status of obligation of these funds. The information is presented in two tables. The report also includes a brief discussion of the impact that sequestration is having on ACA mandatory spending. This report is periodically revised and updated to reflect important legislative and other developments.
- Centers for Disease Control and Prevention Global Health Programs: FY2001-FY2011
- This report explains the role the Centers for Disease Control and Prevention (CDC) plays in U.S. global health assistance, highlights how much the agency has spent on global health efforts from FY2001 to FY2010, and discusses how funding to each of its programs has changed during this period.
- Appropriations and Fund Transfers in the Affordable Care Act (ACA)
- This report summarizes all the mandatory appropriations and Medicare trust fund transfers in the Affordable Care Act (ACA) and provides details on the status of obligation of these funds. The information is presented in two tables. The report also includes a brief discussion of the impact that sequestration is having on ACA mandatory spending.
- Transitional Medical Assistance (TMA) Under Medicaid
- This report provides an overview of transitional medical assistance (TMA). While Section 1925 of the Social Security Act outlines the provisions requiring states to provide TMA for up to 12 months, states have considerable flexibility in designing and implementing their TMA programs.
- Self-Insured Health Insurance Coverage
- This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans.
- Centers for Medicare & Medicaid Services: President’s FY2013 Budget
- This report summarizes the President's budget estimates for each section of the CMS budget. Then, for each legislative proposal included in the President's budget, this report provides a description of current law and the President's proposal. The explanations of the President's legislative proposals are grouped by the following program areas: Medicare, Medicaid, program integrity, and health insurance programs.
- Health Savings Accounts: Overview of Rules for 2012
- This report provides a summary of the principal rules governing Health Savings Accounts (HSAs), covering such matters as eligibility, qualifying health insurance, contributions, and withdrawals.
- Discretionary Spending Under the Affordable Care Act (ACA)
- This report examines the Affordable Care Act's (ACA's) effects on discretionary spending. It first discusses all the ACA authorizations (and reauthorizations) of appropriations for grant and other programs; this information, along with actual funding amounts, is summarized in a series of tables. The report then reviews the ACA administrative costs borne by CMS and the IRS.
- Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System
- This report discusses the Sustainable Growth Rate (SGR), which is the statutory method for determining the annual updates to the Medicare physician fee schedule. The SGR system was established because of the concern that the Medicare fee schedule itself would not adequately constrain overall increases in spending for physicians’ services.
- Federal Drug Price Negotiation: Implications for Medicare Part D
- This report discusses what it means for the federal government to “negotiate” drug prices under existing public programs, the arguments for and against such activities, and some implications for the pharmaceutical industry, Medicare beneficiaries, and others if similar federal involvement were to occur on behalf of the Medicare Part D program.
- Medicaid Expenditures, FY2003 and FY2004
- This report discusses the federal medical assistance percentage (FMAP), which is the percentage of Medicaid benefit costs paid for by the federal government.
- Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System
- This report provides a background on the Medicare fee schedule, the Sustainable Growth Rate (SGR) system, and the annual updates and discusses recent proposals to address this issue.
- Health Care and Markets
- Health care spending is one of the most rapidly growing portions of the federal budget. Projections suggest if the rapid growth in health care costs is not curtailed, governments at all levels will face an uncomfortable choice between significant cuts in other spending priorities or major tax increases. This report examines the economic justification for government intervention and involvement in health care markets.
- Health-Related Tax Expenditures: Overview and Analysis
- This report analyzes health-related tax expenditures together at the budget function level, rather than focusing on the size of any single provision. To provide some insights into common questions about health-related expenditures, this report analyzes historical data on health-related tax expenditure estimates published by the Joint Committee on Taxation (JCT).
- Self-Insured Health Insurance Coverage
- This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans.
- Health Maintenance Organization Act of 1973 (P. L. 93-222)
- This report discusses the provisions of the Health Maintenance Organization Act of 1973 (P. L. 93-222) which provided funding to assist in the start-up of health maintenance organizations (HMO).
- Discretionary Spending Under the Affordable Care Act (ACA)
- This report examines the Affordable Care Act's (ACA's) effects on discretionary spending. It first discusses all the ACA authorizations (and reauthorizations) of appropriations for grant and other programs; this information, along with actual funding amounts, is summarized in a series of tables. The report then reviews the ACA administrative costs borne by CMS and the IRS.