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Health Care: Constitutional Rights and Legislative Powers

Description: This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. It also discusses legal issues that have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to "nullify" or "opt out" of such a requirement.
Date: April 5, 2010
Creator: Swendiman, Kathleen S.
Partner: UNT Libraries Government Documents Department

Health Care: Constitutional Rights and Legislative Powers

Description: The health care reform debate raises many complex issues including those of coverage, accessibility, cost, accountability, and quality of health care. Underlying these policy considerations are issues regarding the status of health care as a constitutional or legal right. This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. Following the recent passage of the Patient Protection and Affordable Care Act, P.L. 111-148, legal issues have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to "nullify" or "opt out" of such a requirement. These issues are also discussed.
Date: May 18, 2010
Creator: Swendiman, Kathleen S.
Partner: UNT Libraries Government Documents Department

School-Based Health Centers: Available Information on Federal Funding

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "Many of our nation's children have difficulty accessing needed health care services. In 2008, the Robert Wood Johnson Foundation reported that about 25 percent of children with insurance and about 55 percent of uninsured children did not receive a recommended routine checkup within the previous year. According to the Department of Health and Human Services (HHS), children face growing risks from chronic physical conditions such as asthma and obesity and from mental health disorders such as depression, and yet, as we have reported, their access to services may be impeded by a number of barriers, including a lack of health insurance and a lack of convenient transportation to medical appointments. Access to mental health care services may also be impeded by concerns about stigma--negative attitudes and beliefs often associated with receiving such care--which can be a deterrent to seeking these services. To help increase children's access to primary health care and other health care services, states and communities have established school-based health centers (SBHC). SBHCs are located on school grounds, provide health care services regardless of ability to pay, and offer a broader range of services than a school nurse generally provides. Almost all SBHCs provide primary care, and they vary in the extent to which they provide other health care services, such as immunizations, behavioral health care, oral health care, health and nutrition education, and reproductive health care. SBHCs improve children's access to health care services by reducing financial and other barriers to care, especially for children who are poor or uninsured. For example, as we reported in our July 2009 report on children's access to mental health care services following Hurricane Katrina, SBHCs in Louisiana have emerged as a key approach to providing access to primary ...
Date: October 8, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Medicare Recovery Audit Contracting: Weaknesses Remain in Addressing Vulnerabilities to Improper Payments, Although Improvements Made to Contractor Oversight

Description: A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare & Medicaid Services (CMS) conducted a mandated 3-year project from March 2005 through March 2008 to demonstrate the use of recovery audit contractors (RAC) in identifying Medicare improper payments and recouping overpayments. CMS implemented a mandated national RAC program, which began in March 2009. GAO was asked to examine specific issues that arose during the demonstration project and CMS's efforts to address them in the national RAC program. This report examines the extent to which CMS (1) developed a process and took corrective actions to address vulnerabilities identified by the RACs that led to improper payments, (2) resolved coordination issues between the RACs and the Medicare claims administration contractors, and (3) established methods to oversee RAC claim review accuracy and provider service during the national program. GAO reviewed CMS documents and interviewed officials from CMS and contractors and provider groups affected by the demonstration project."
Date: March 31, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

State and Local Governments: Fiscal Pressures Could Have Implications for Future Delivery of Intergovernmental Programs

Description: A letter report issued by the Government Accountability Office with an abstract that begins "State and local governments work in partnership with the federal government to implement numerous intergovernmental programs. Fiscal pressures for state and local governments may exist when spending is expected to outpace revenues for the long term. GAO was asked to examine (1) the long-term fiscal pressures facing state and local governments and historical spending and revenue trends, (2) spending and revenue trends to identify patterns among states, and (3) what is known about the implications of these fiscal pressures for federal policies. Using aggregate data from the Bureau of Economic Analysis's National Income and Product Accounts, this analysis draws on results from the March 2010 update to GAO's state and local government fiscal model. GAO's model uses historical data to simulate expenditures and revenues for the sector for the next 50 years. Data from the U.S. Census Bureau are used to analyze patterns of state and local government expenditures and revenues among the states from 1977 to 2007, the most recent 30-year period for which these data were available. A review of GAO and other reports synthesizes what is known about the implications of these long-term fiscal pressures for future federal policies."
Date: July 30, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Medicare Advantage: CMS Actions Regarding Plans' Health Reform Communications

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "In August and September 2009, Humana--a large private health insurer--sent a letter to the approximately 930,000 beneficiaries enrolled in its Medicare Advantage (MA) plans, advising that leading health reform proposals could adversely affect MA beneficiaries. Signed by Humana's Chief Medical Officer, the letter stated that if proposed funding cuts became law, "millions of seniors and disabled individuals could lose many of the important benefits and services that make MA health plans so valuable," and encouraged beneficiaries to contact their members of Congress and ask them to protect MA funding. Once the Centers for Medicare & Medicaid Services (CMS) learned about the mailing, the agency directed Humana on September 18, 2009, and all other MA organizations on September 21, 2009, to immediately stop all communications to beneficiaries about the potential impact of health reform legislation while CMS investigated whether such communications violated federal laws, regulations, or MA program guidance. CMS issued clarifying guidance to all MA organizations on October 16, 2009, and took compliance action against some organizations, closing its investigation. CMS is responsible for overseeing communications between MA organizations and beneficiaries enrolled in their plans. Because MA organizations are Medicare contractors, communications to beneficiaries must comply with various requirements, including marketing guidelines and restrictions on the use of beneficiary information obtained from CMS databases. CMS requires that MA organizations submit marketing materials--defined as materials targeted to beneficiaries that, among other things, provide information on plan benefits--to the agency for review and may impose penalties for distributing marketing material inappropriately. This report responds to your request that we review CMS's actions in response to MA plan communications to beneficiaries about pending health reform legislation. We examined: 1. how CMS learned that Humana sent a mailing to beneficiaries on the ...
Date: September 20, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Consumer-Directed Health Plans: Health Status, Spending, and Utilization of Enrollees in Plans Based on Health Reimbursement Arrangements

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Consumer-directed health plans (CDHP) combine a high-deductible health plan with a tax-advantaged account, such as a health reimbursement arrangement (HRA), that enrollees can use to pay for health care expenses. In an effort to restrain cost growth, several employers, including the federal government through its Office of Personnel Management (OPM), have offered HRAs for several years. For enrollees in HRAs compared with those in traditional plans such as preferred provider organization (PPO) plans, GAO assessed (1) differences in health status, and (2) changes in spending and utilization of health care services. GAO analyzed data from two large employers--one public and one private--that introduced an HRA option in 2003. GAO compared changes in health spending and utilization before and after 2003 for enrollees who switched from a PPO into an HRA (the HRA group) with those who stayed in a PPO (the PPO group). At the time GAO made its data requests to each employer, 2007 data from the public employer and 2005 data from the private employer were the most current and complete data available. GAO also reviewed published studies that included an assessment of the health status, spending, or utilization of HRA and other CDHP enrollees compared with traditional plan enrollees. Results are not generalizable beyond the enrollees, health plans, and employers GAO reviewed and also cannot be compared between the public and private employers."
Date: July 16, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

End-Stage Renal Disease: CMS Should Monitor Access to and Quality of Dialysis Care Promptly after Implementation of New Bundled Payment System

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Medicare covers dialysis for most individuals with end-stage renal disease (ESRD). Beginning in January 2011, the Centers for Medicare & Medicaid Services (CMS) is required to use a single payment to pay for dialysis and related services, which include injectable ESRD drugs. Questions have been raised about this new payment system's effects on the access to and quality of dialysis care for certain groups of beneficiaries, such as those who receive above average doses of injectable ESRD drugs. GAO examined (1) Medicare expenditures for injectable ESRD drugs, by demographic characteristics; (2) factors likely to result in above average doses of these drugs; (3) CMS's approach for addressing beneficiary differences in the cost of dialysis care under the new payment system; and (4) CMS's plans to monitor the new payment system's effects. GAO analyzed 2007 data--the most recent available--on Medicare ESRD expenditures and input from 73 nephrology clinicians and researchers collected using a Web-based data collection instrument. GAO also reviewed reports and CMS's proposed rule on the payment system's design and interviewed CMS officials."
Date: March 31, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Medicaid and CHIP: Enrollment, Benefits, Expenditures, and Other Characteristics of State Premium Assistance Programs

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "Fiscal pressures, rising health care costs, and increases in the number of uninsured may lead states to look toward public-private partnerships to help finance health insurance coverage. Through Medicaid and the State Children's Health Insurance Program (CHIP), states have had long-standing authority to operate premium assistance programs that subsidize the purchase of private health insurance. Enacted in February 2009, the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which reauthorized CHIP and made changes to Medicaid, provided states with additional options for operating premium assistance programs. As of November 2009, states had not implemented premium assistance programs under the new authorities provided by CHIPRA, but, as allowed by CHIPRA, states were continuing to operate their programs under preexisting authorities. Through premium assistance programs, states use Medicaid funds, CHIP funds, or both to subsidize the cost of private health insurance--such as employer-sponsored insurance (ESI)--for eligible individuals. As such, premium assistance programs contrast with direct coverage, where states provide Medicaid or CHIP benefits to enrollees by paying doctors and other providers directly or contracting with managed care organizations. Previous reports on premium assistance programs have described the programs' potential benefits, as well as potential issues that have been raised about them. One potential benefit reported is that premium assistance programs could generate cost savings for Medicaid and CHIP by leveraging private financial resources for health insurance coverage--such as employer contributions--and decreasing enrollment in direct coverage. Additional potential benefits include helping families make the transition to private health insurance, expanding coverage to family members who are not themselves eligible for coverage under Medicaid or CHIP, and supporting the private insurance market. In contrast, a reported issue with premium assistance programs is that there may be disparities in the benefits and ...
Date: January 19, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Medicare Advantage: Relationship between Benefit Package Designs and Plans' Average Beneficiary Health Status

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Nearly 11 million Medicare beneficiaries are enrolled in Medicare Advantage (MA), Medicare's private health insurance option. Benefits vary by MA plan and may include coverage for services not available in traditional Medicare. To ensure MA plan benefit package designs do not discriminate against beneficiaries in poor health with high expected health care costs, the Centers for Medicare & Medicaid Services (CMS) reviews and approves all benefit packages yearly. GAO examined (1) MA plan benefit packages by average health status of plans' enrolled beneficiaries, (2) distribution and characteristics of MA plans by average beneficiary health status, and (3) CMS's process for ensuring that benefit packages do not discriminate with respect to health status. Using 2008 data on beneficiaries' expected health care costs, the most recent data available, GAO sorted 2,899 plans enrolling 7.5 million beneficiaries into three groups: good health (below-average expected costs), average health, and poor health (above-average expected costs). GAO then analyzed MA plan benefit packages by health group and reviewed CMS documentation and interviewed agency officials on CMS's benefit package review process. GAO did not determine whether plans structured benefit packages in response to enrolled beneficiaries' health status or beneficiaries in particular health groups chose plans because of the benefits."
Date: April 30, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Children with Down Syndrome: Families Are More Likely to Receive Resources at Time of Diagnosis Than in Early Childhood

Description: A letter report issued by the Government Accountability Office with an abstract that begins "On October 8, 2008, the Prenatally and Postnatally Diagnosed Conditions Awareness Act was signed into law, requiring GAO to submit a report concerning the effectiveness of current health care and family support programs for the families of children with disabilities. In this report, GAO focused on Down syndrome because it is a medical condition that is associated with disabilities and occurs frequently enough to yield a sufficient population size for an analysis. GAO examined (1) what is known about the extent to which children with Down syndrome receive medical care during early childhood and (2) what resources families of children with Down syndrome receive through their health care providers and what barriers families face to using these resources. GAO analyzed fee-for-service claims data from a very large private health insurance company, for the claims representing its experience with one of the largest national employers, and Medicaid claims data from seven states with high Medicaid enrollment and low percentages of enrollees in Medicaid managed care. GAO also interviewed specialists at six prominent Down syndrome clinics and 12 advocacy groups to examine what resources families receive and to identify barriers they face. GAO also analyzed data from the Health Resources and Services Administration-sponsored 2005-2006 National Survey of Children with Special Health Care Needs on barriers to accessing needed services."
Date: October 8, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

VA Health Care: Improved Oversight and Compliance Needed for Physician Credentialing and Privileging Processes

Description: A letter report issued by the Government Accountability Office with an abstract that begins "VA has policies to ensure that physicians have appropriate qualifications and clinical abilities through the processes of credentialing, privileging, and continuous monitoring of performance. Results of a VA investigatory report in 2008 cited deficiencies in the Marion, Illinois, VA medical center's (VAMC) credentialing and privileging processes and oversight of its surgical program. This report examines VA's policies and guidance to help ensure that information about physician qualifications and performance is accurate and complete, VAMCs' compliance with selected VA credentialing and privileging policies, and their implementation of VA policies to continuously monitor performance. The Government Accountability Office (GAO) reviewed VA's policies, interviewed VA officials, and reviewed a judgmental sample of 30 credentialing and privileging files at each of six VAMCs that GAO visited. GAO selected the files to ensure inclusion of highly paid specialties, newly hired physicians, and other physician characteristics. GAO selected the judgmental sample of six VAMCs based on geographic balance and other factors."
Date: January 6, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Health Coverage Tax Credit: Participation and Administrative Costs

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "This report is in response to section 1899L of the American Recovery and Reinvestment Act of 2009. The statute required the Comptroller General to examine issues related to participation in and administrative costs associated with the Health Coverage Tax Credit program administered by the Internal Revenue Service (IRS) in the Department of the Treasury, and to provide the results to Congress by March 1, 2010."
Date: April 30, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Food and Drug Administration: Improved Monitoring and Development of Performance Measures Needed to Strengthen Oversight of Criminal and Misconduct Investigations

Description: A letter report issued by the Government Accountability Office with an abstract that begins "The Food and Drug Administration (FDA) is responsible for protecting public health by regulating products such as prescription drugs and vaccines and has the authority to investigate alleged criminal activity related to FDA-regulated products, for example on the sale of counterfeit drugs. Within FDA, the Office of Criminal Investigations (OCI) investigates individuals and companies external to FDA. FDA also has the authority to investigate allegations of FDA employee misconduct and these internal investigations are conducted by the Office of Internal Affairs (OIA), a distinct office within OCI. GAO was asked to examine FDA's (1) oversight of OCI investigations, (2) oversight of OIA investigations, and (3) funding, staffing, and workload for OCI. GAO interviewed agency officials, reviewed FDA documents including those describing its investigative policies, and examined FDA data on OCI resources and workload, from fiscal years 1999 to 2008."
Date: January 29, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

License Suspensions for Nondriving Offenses: Practices in Four States That May Ease the Financial Impact on Low-Income Individuals

Description: A letter report issued by the Government Accountability Office with an abstract that begins "States suspend driver's licenses for a variety of offenses that are not directly related to driving safety. For example, all states have procedures to suspend licenses for child support arrearages. In addition, a majority of states issue suspensions for such offenses as failure to pay court or motor vehicle fines or maintain proper insurance. While recognizing that license suspension can be an effective tool for encouraging compliance with various laws, some policymakers and advocacy groups have raised concerns that certain drivers may face suspension because of their limited ability to meet financial obligations. They have also raised concerns that suspensions make it difficult for some low-income individuals to maintain or find work, and may make it more challenging for them to pay fines or meet child support obligations. Additionally, they have raised concerns that suspensions for nondriving offenses may clog court systems and divert resources to activities that do not improve traffic safety. Although the federal government has a limited role with regard to driver's licenses, federal law promotes nondriving suspensions in two circumstances. First, as a condition of federal funding for their child support enforcement programs, states are required to provide for license suspensions for individuals delinquent in making child support payments. Second, 10 percent of certain federal highway funds are contingent upon a state (a) enacting and enforcing a law that suspends driver's licenses, in all cases, or except in compelling circumstances, for individuals convicted of drug offenses, or (b) its governor certifying that he or she is opposed to such a law and that the state legislature has adopted a resolution opposing it. Thirty-two states have chosen the second option. While there has been interest in nondriving suspensions in recent years, little is ...
Date: February 18, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Oral Health: Efforts Under Way to Improve Children's Access to Dental Services, but Sustained Attention Needed to Address Ongoing Concerns

Description: A letter report issued by the Government Accountability Office with an abstract that begins "The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) required GAO to study children's access to dental care. GAO assessed (1) the extent to which dentists participate in Medicaid and the Children's Health Insurance Program (CHIP) and federal efforts to help families find participating dentists; (2) data on access for Medicaid and CHIP children in different states and in managed care; (3) federal efforts to improve access in underserved areas; and (4) how states and other countries have used mid-level dental providers to improve children's access. To do this, GAO (1) examined state reported dentist participation and the Department of Health and Human Services's (HHS) Insure Kids Now Web site for all 50 states and the District of Columbia and called a non-representative sample of dentists in four states; (2) reviewed national data on provision of Medicaid dental services and use of managed care; (3) interviewed HHS officials and assessed certain HHS dental programs; and (4) interviewed officials in eight states and four countries on the use of mid-level and other dental providers."
Date: November 30, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Nursing Homes: Complexity of Private Investment Purchases Demonstrates Need for CMS to Improve the Usability and Completeness of Ownership Data

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Since 2007, attention has been focused on nursing home ownership by private investment (PI) firms. Nursing home providers are required to disclose parties with an ownership or control interest in order to participate in Medicare or Medicaid. CMS, the HHS agency responsible for managing these two programs, maintains ownership and chain data in its Provider Enrollment, Chain, and Ownership System (PECOS). GAO examined (1) the extent of PI nursing home ownership and firms' involvement in homes' operations, (2) whether PECOS reflects PI ownership, and (3) how HHS and states use ownership data for oversight. GAO identified PI ownership using a proprietary database and analyzed data from six PI firms about their interest and involvement in nursing homes. GAO examined PECOS data for selected PI-owned nursing home chains and discussed ownership data with officials from HHS, CMS, and six states that also collect data."
Date: September 30, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Medicare: CMS Needs to Collect Consistent Information from Quality Improvement Organizations to Strengthen Its Establishment of Budgets for Quality of Care Reviews

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "Medicare funds health care services for more than 46 million beneficiaries. The Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare--contracts with private organizations known as Quality Improvement Organizations (QIO) to, among other core functions, improve the quality of care for Medicare beneficiaries. CMS contracts with one QIO for each of the 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. One of the QIOs' many responsibilities is to review quality of care concerns, raised by Medicare beneficiaries or others, to determine whether Medicare-financed medical services meet professionally recognized standards of health care. Quality of care reviews may address a range of issues, such as inappropriate treatment or hospital staff not administering medications on time; may involve a variety of health care services and settings; and may include a range of Medicare providers or practitioners. CMS enters into 3-year contracts with QIOs for a range of activities and reviews, including quality of care reviews. For each QIO contract, CMS establishes a budget reflecting the estimated costs of these activities and reviews. For the most recent contracts, which cover August 1, 2008, through July 31, 2011, CMS's budgets for the QIOs totaled about $1.1 billion, with approximately $208 million for all types of reviews, including QIOs' quality of care reviews, as well as some other activities. Questions have been raised about CMS's ability to set budgets appropriately for QIOs' quality of care reviews. A 2006 report by the Institute of Medicine (IOM) and a 2008 internal report commissioned by CMS identified weaknesses in CMS's ability to accurately compare costs across QIOs. Based on reports of wide variation in the costs that QIOs report for conducting these reviews, Congress raised questions about how CMS ...
Date: December 6, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Group Purchasing Organizations: Services Provided to Customers and Initiatives Regarding Their Business Practices

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Health care providers rely on group purchasing organizations (GPO) to negotiate contracts with vendors of medical products. In 2002, questions were raised about GPOs engaging in potentially anticompetitive business practices such as collecting excessively high contract administrative fees. In 2003, GAO reported that selected GPOs had adopted or revised codes of conduct to respond to the questions about their business practices, but that it was too soon to evaluate the impact of the codes of conduct. GAO was asked to provide information on GPOs. In this report, GAO describes (1) the types of services that GPOs provide and how the GPOs fund these services, (2) initiatives that GPOs have implemented since 2002 to address the questions that had been raised about their business practices, and (3) the reported impact of the GPOs' codes of conduct and other initiatives. To do its work, GAO reviewed GPO documents and collected written responses to structured questions from the six largest GPOs based on their reported 2007 purchasing volume. GAO also conducted follow-up interviews with these six GPOs. GAO interviewed representatives from six GPO customers--hospitals--that varied in size, the GPOs with which they did business, and whether they had an ownership stake in a GPO. GAO also interviewed five medical product vendors of various sizes that do business with GPOs."
Date: August 24, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Poorly Performing Nursing Homes: Special Focus Facilities Are Often Improving, but CMS's Program Could Be Strengthened

Description: A letter report issued by the Government Accountability Office with an abstract that begins "CMS established the Special Focus Facility (SFF) Program in 1998 to help address poor nursing home performance. States select a subset of homes as SFFs from a list of the 15 poorest performing homes in each state, but the program is limited to 136 homes nationwide because of resource constraints. CMS guidance directs states to survey SFFs twice as frequently as other homes and to propose more robust enforcement, including termination, for SFFs that fail to improve within about 18 months. GAO was asked to (1) determine the factors states consider in selecting SFFs and how SFFs differed from other nursing homes, (2) evaluate CMS regional office and state adherence to program guidance and the program's impact on homes' performance, and (3) identify other strategies that have been used to improve poorly performing homes. In general, GAO's analysis used CMS data from 2005 through 2009 on SFFs and other homes as well as interviews with officials in 14 states selected based on the number of SFFs in each state and other factors."
Date: March 19, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Group Purchasing Organizations: Research on Their Pricing Impact on Health Care Providers

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "Hospitals and other health care providers use purchasing intermediaries--group purchasing organizations (GPO)--as a way to control the cost of various medical products. Through GPO-negotiated contracts, hospitals and other health care providers can purchase everything from commodities, such as cotton balls and bandages, to high-technology medical devices, such as pacemakers and stents. By pooling the purchases of these products for their customers, GPOs are in a position to negotiate lower prices from manufacturers, distributors, and other suppliers, which may in turn benefit health care providers and, ultimately, consumers and payers of health care such as insurers and employers. Members of Congress and others have recently raised questions about the extent to which GPOs negotiate lower prices for health care providers. GPO and other trade associations have funded studies on the impact of GPOs. However, these studies have limitations. Congress asked us to review research on the impact of GPOs on pricing for hospitals and other health care providers. This report summarizes the peer-reviewed and nonpeer-reviewed literature on the impact of GPOs on pricing for hospitals and other health care providers that GAO identified in GAO's literature review."
Date: January 29, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department

Veterans Affairs: Health Care and Benefits for Veterans Exposed to Agent Orange

Description: This report provides an overview of health care services and disability compensation benefits available to Vietnam veterans, Children of Vietnam Era veterans, and non-Vietnam veterans exposed to herbicides. This is followed by a discussion of litigation pertaining to Navy veterans of the Vietnam Era who served offshore and were never physically present on Vietnamese soil. The report concludes with a discussion of epidemiologic research conducted to study the health effects of Agent Orange and dioxin exposure on Vietnam veterans.
Date: September 22, 2010
Creator: Panangala, Sidath Viranga & Weimer, Douglas Reid
Partner: UNT Libraries Government Documents Department

Hurricane Katrina: CMS and HRSA Assistance to Sustain Primary Care Gains in the Greater New Orleans Area

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "More than 4 years after Hurricane Katrina made landfall, the greater New Orleans area continues to face challenges restoring health care services disrupted by the storm and flooding that followed. In July 2007, the U.S. Department of Health and Human Services (HHS) awarded the $100-million Primary Care Access and Stabilization Grant (PCASG) to the Louisiana Department of Health and Hospitals (LDHH). The PCASG was intended to restore and expand access to primary care services in the greater New Orleans area without regard to a patient's ability to pay. The PCASG was designed to provide a temporary funding source--from July 23, 2007, through September 30, 2010. Despite the various types of assistance offered, concerns remain about whether the primary care gains made will be sustainable after the PCASG funding ends. Given the federal investment in providing and sustaining health care in the greater New Orleans area, Congreess asked GAO to describe what steps CMS and the Health Resources and Services Administration (HRSA) have taken to help the PCASG-funded organizations--LDHH, LPHI, and the PCASG-funded providers--sustain the primary care gains made in the greater New Orleans area."
Date: June 30, 2010
Creator: United States. Government Accountability Office.
Partner: UNT Libraries Government Documents Department