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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.
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.
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.
The Pros and Cons of Allowing the Federal Government to Negotiate Prescription Drug Prices
The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) expressly forbids the Secretary of Health and Human Services (HHS) from negotiating the price of prescription drugs on behalf of Medicare beneficiaries. This report outlines the arguments for and against allowing the federal government to negotiate prescription drug prices on behalf of Medicare beneficiaries. This report will be updated, as needed.
Standardized Choices: Medigap Lessons for Medicare Part D
No Description Available.
Medicaid Reimbursement Policy
This report begins with a summary of basic federal requirements applicable to payments for all services and an overview of major developments in federal Medicaid reimbursement policy over the last 20 years. This overview provides a historical context for current policies and highlights some issues that have been perennial concerns for federal and state policymakers. The next four sections of the report provide a detailed discussion of Medicaid reimbursement for four basic categories of services or providers.
Social Security and Medicare "Lock Boxes"
With the onset of burgeoning federal budget surpluses, Social Security and Medicare's treatment in the budget has become a major policy issue. Congressional views about what to do with the surpluses are diverse -- ranging from "buying down" the federal government's outstanding debt to cutting taxes to increasing spending.
Social Security and Medicare "Lock Boxes"
No Description Available.
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.
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.
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
Medicare: Payments to Physicians
This report discusses payments for physicians services under Medicare that are made on the basis of a fee schedule.
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.
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.
Older Workers: Employment and Retirement Trends
As the members of the “baby boom” generation — people born between 1946 and 1964— approach retirement, the demographic profile of the U.S. workforce will undergo a substantial shift: a large number of older workers will be joined by relatively few new entrants to the labor force. According to the U.S. Bureau of the Census, while the number of people between the ages of 55 and 64 will grow by about 11 million between 2005 and 2025, the number of people who are 25 to 54 years old will grow by only 5 million. This trend could affect economic growth because labor force participation begins to fall after age 55. In 2004, 91% of men ages 25 to 54 and 75% of women in this age group participated in the labor force. In contrast, just 69% of men ages 55 to 64 and 56% of women ages 55 to 64 were either working or looking for work in 2004.
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.
Medicare: Physician Payments
This report discusses payments for physicians services under Medicare that are made on the basis of a fee schedule.
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.
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.
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.
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.
Medicaid, SCHIP, and Other Health Provisions in H.R. 5661: Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000
This report discusses Medicaid and the State Children’s Health Insurance Program (SCHIP). The report also discusses other major health provisions provisions of H.R. 5661 are incorporated, by reference into H.R. 4577, the Consolidated Appropriations Act 2001.
Medicare Provisions in the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA, P.L. 106-554)
No Description Available.
Social Security and Medicare Taxes and Premiums: Fact Sheet
No Description Available.
Social Security and Medicare Taxes and Premiums: Fact Sheet
No Description Available.
Nursing Homes and the Congress: A Brief History of Developments and Issues
No Description Available.
Summary of the Medicare Regulatory and Contracting Reform Act of 2001 (H.R. 3391)
No Description Available.
Medicare Structure Reform: Background and Options
No Description Available.
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.
Pharmacy Benefit Managers
No Description Available.
President Bush's Proposed Medicare-Endorsed Drug Discount Card Initiative: Status and Issues
No Description Available.
President Bush's Proposed Medicare-Endorsed Drug Discount Card Initiative: Status and Issues
No Description Available.
Medicare: Major Prescription Drug Provisions of Selected Bills
No Description Available.
Medicare: Major Prescription Drug Provisions of Selected Bills
No Description Available.
Medicare: Major Prescription Drug Provisions of Selected Bills
No Description Available.
Increases in Tricare Costs: Background and Options for Congress
In its FY2007 budget submission, the Department of Defense (DOD) proposed increases in Tricare enrollment fees, deductibles, and pharmacy co-payments for retired beneficiaries not yet eligible for Medicare. The raises were justified by DOD as necessary to constrain the growth of health care spending as a proportion of the overall defense budget in the next decade. Many beneficiaries argued that the proposed hikes were unfair and unnecessary. The FY2007 Defense Authorization Act prohibited increases in premiums, deductibles, and co-payments prior to September 30, 2007. The FY2008 National Defense Authoriztion Act extended the prohibition of increases in co-payments and enrollment fees until October 2008 and Congress may move to extend them further.
Medicare: Beneficiary Cost-Sharing Under Prescription Drug Legislation
This report provides an analysis of how the cost-sharing and premium provisions under the Prescription Drug and Medicare Improvement Act of 2003 (S. 1) and the Medicare Prescription Drug and Modernization Act of 2003 (H bill would affect the amount that a beneficiary would pay annually for prescription drugs.
Medicare: Beneficiary Cost-Sharing Under Proposed Prescription Drug Benefits
This report examines these proposals as well as the “Medicare Rx Drug Benefit and Discount Act of 2003,” which was introduced by Representative Charles Rangel, the ranking member of the House Ways and Means Committee. Specifically, 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.
President Bush's Proposed Medicare-Endorsed Drug Discount Card Initiative: Status and Issues
No Description Available.
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.
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.
Concurrent Receipt: Background and Issues for Congress
"Concurrent Receipt" refers to the simultaneous receipt of two types of monetary benefits: military retired pay and Department of Veterans Affairs (VA) disability compensation. This report addresses the two primary components of the concurrent receipt program: Combat-Related Special Compensation (CRSC) and Concurrent Retirement and Disability Payments (CRDP). It reviews the possible legislative expansion of the program to additional populations and provide several potential options for Congress to consider.
A CRS Review of 10 States: Home and Community-Based Services — States Seek to Change the Face of Long-Term Care: Indiana
Many states have devoted significant efforts to respond to the desire for home and community-based care for persons with disabilities and their families. Nevertheless, financing of nursing home care, chiefly by Medicaid, still dominates most states’ spending for long-term care today. To assist Congress in understanding issues that states face in providing long-term care services, the Congressional Research Service (CRS) undertook a study of 10 states in 2002. This report, one in a series of 10 state reports, presents background and analysis about long-term care in Indiana.
Low-Income Home Energy Assistance Program (LIHEAP): Formula and Estimated Allocations
This report reviews how allotments of regular LIHEAP funding are determined and how these calculations change at different funding levels. Included is a description of the components of the new LIHEAP formula rates.
Supplemental Security Income (SSI): A Fact Sheet
The Supplemental Security Income (SSI) program, Title XVI of the Social Security Act, was enacted in 1972 and implemented in 1974 to assure a minimum cash income to all aged, blind, or disabled persons. SSI is provided to eligible aged or disabled individuals or couples who have limited income and resources.
End-of-Life Care: Services, Costs, Ethics, and Quality of Care
This report provides information on various aspects of end-of-life care: (1) demographic and historical changes affecting death and dying in the United States (2) the definitions of end-of-life, palliative, and hospice care (3) costs associated with end-of-life care (4) end-of-life care laws and ethics (5) quality of care at the end of life and (6) policy issues that would modify or expand the federal government's role in addressing end-of-life care.
Medicare Prescription Drug and Reform Legislation
This report describes the major features of S. 1, as ordered reported, and the measure to be considered by the House Ways and Means Committee, H.R. 2473, as ordered reported.
Overview of the Medicare Prescription Drug and Reform Legislation
No Description Available.
Medicare Prescription Drug Provisions of S.1, as Passed by the Senate, and H.R. 1, as Passed by the House
This report discusses differences in the specifics of the prescription drug provisions in S. 1 and H.R. 1 and provides a side-by-side comparison of the Title I provisions of both bills.
Implications of the Medicare Prescription Drug Benefit for State Budgets
No Description Available.
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