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Medicare Advantage: CMS Assists Beneficiaries Affected by Inappropriate Marketing but Has Limited Data on Scope of Issue

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Members of Congress and state agencies have raised questions about complaints that some Medicare Advantage (MA) organizations and their agents inappropriately marketed their health plans to Medicare beneficiaries. Inappropriate marketing may include activities such as providing inaccurate information about covered benefits and conducting prohibited marketing practices. The Centers for Medicare & Medicai… more
Date: December 17, 2009
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
open access

Medicare Advantage: Characteristics, Financial Risks, and Disenrollment Rates of Beneficiaries in Private Fee-for-Service Plans

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Medicare Advantage (MA) plans are an alternative to the original Medicare fee-for-service (FFS) program. Private fee-for-service (PFFS) plans--one type of MA plan--give beneficiaries an option that is more like Medicare FFS than other MA plans, with a wider choice of providers and less plan management of services and providers. PFFS enrollment increased from about 35,000 beneficiaries in June 2004 to ab… more
Date: December 15, 2008
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
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Medicare Physician Fee Schedule: CMS Needs a Plan for Updating Practice Expense Component

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Medicare's payments for the costs physicians incur in operating their practices are based on two sets of estimates: total practice expenses and resource estimates for individual services. Total practice expense estimates were derived from American Medical Association (AMA) physician surveys, which the Centers for Medicare & Medicaid Services (CMS) refines with supplemental data submitted by medical spec… more
Date: December 13, 2004
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
open access

Medicare: Post-Hearing Questions Related to Financial and Information Technology Management

Description: Correspondence issued by the General Accounting Office with an abstract that begins "This correspondence answers congressional questions about financial and information technology management of the Medicare Program. Among the topics discussed are claims processing, management of statistical data, and computer viruses. For example, in reference to claims processing, GAO found that, as of December 2000, Medicare carriers and fiscal intermediaries use six standard claims processing systems to proc… more
Date: December 21, 2000
Creator: United States. General Accounting Office.
Item Type: Refine your search to only Text
Partner: UNT Libraries Government Documents Department
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Medicare Advantage: 2011 Profits Similar to Projections for Most Plans, but Higher for Plans with Specific Eligibility Requirements

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Medicare Advantage (MA) organizations' actual medical expenses, nonmedical expenses (such as marketing, sales, and administration) and profits as a percentage of total revenue were, on average, similar to projected values for plans available to all beneficiaries in 2011, the most recent year for which data were available at the time of the request for this work. MA organizations' actual medical expenses… more
Date: December 19, 2013
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
open access

Medicare: Callers Can Access 1-800-MEDICARE Services, but Responsibility within CMS for Limited English Proficiency Plan Unclear

Description: A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare & Medicaid Services (CMS) is responsible for providing beneficiaries timely and accurate information about Medicare. Receiving nearly 30 million calls in 2007, 1-800-MEDICARE, operated by a contractor, is the most common way members of the public get program information. The help line provides services both to English-speaking and limited English proficiency (LEP) callers. In th… more
Date: December 29, 2008
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
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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 … more
Date: December 6, 2010
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Text
Partner: UNT Libraries Government Documents Department
open access

Medicare and Medicaid Coverage: Therapies and Supplies for Inflammatory Bowel Disease

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Inflammatory bowel disease (IBD) affects an estimated one million Americans. IBD patients often have difficulty digesting food. As a result, they may require parenteral nutrition (intravenous feeding) or enteral nutrition (tube feeding), medically necessary food products to supplement their diets, and medications. In addition, some IBD patients must care for their ostomies--surgically created openings f… more
Date: December 15, 2005
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
open access

Medicare: Accuracy of Responses from the 1-800-MEDICARE Help Line Should Be Improved

Description: A letter report issued by the Government Accountability Office with an abstract that begins "In March 1999, the Centers for Medicare & Medicaid Services (CMS) implemented a telephone help line--1-800-MEDICARE--to provide information about program eligibility, enrollment, and benefits. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) directed GAO to examine several issues related to this 24-hour help line and the customer service representatives (CSRs) who staff i… more
Date: December 8, 2004
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
open access

Medicare Chemotherapy Payments: New Drug and Administration Fees Are Closer to Providers' Costs

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) required the Secretary of the Department of Health and Human Services to change the payment rates for chemotherapy-related drugs and chemotherapy administration services. These changes followed reports that Medicare payments for chemotherapy-related drugs were much higher than physicians' costs to acquire them, and oncologis… more
Date: December 1, 2004
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Text
Partner: UNT Libraries Government Documents Department
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Medicare Advantage: Changes Improved Accuracy of Risk Adjustment for Certain Beneficiaries

Description: A letter report issued by the Government Accountability Office with an abstract that begins "The effect of CMS's revised community model on payment accuracy varied for the high-risk groups studied. Specifically, compared with the current community model, the revised community model slightly reduced the accuracy of MA payment adjustments for beneficiaries with multiple chronic conditions by $164, or about 1 percent of average actual expenditures. For beneficiaries with low income, the accuracy o… more
Date: December 9, 2011
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
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Medicare Advantage Organizations: Actual Expenses and Profits Compared to Projections for 2006

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "The federal government's spending on the Medicare Advantage (MA) program has grown substantially in recent years, from approximately $60 billion in 2006 and $77 billion in 2007 to an estimated $91 billion in 2008. MA organizations provide health care coverage to Medicare beneficiaries through private health plans, thus offering an alternative to the original Medicare fee-for-service (FFS) program. Paymen… more
Date: December 8, 2008
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Text
Partner: UNT Libraries Government Documents Department
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Medicare: Continuous Insurance before Enrollment Associated with Better Health and Lower Program Spending

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Beneficiaries with continuous health insurance coverage for approximately 6 years before enrolling in Medicare were more likely than those without prior continuous insurance to report being in good health or better during the first 6 years in Medicare. In particular, having prior continuous insurance raised the predicted probability that a beneficiary reported being in good health or better by nearly 6 … more
Date: December 17, 2013
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
open access

Medicare: Contingency Plans to Address Potential Problems with the Transition of Dual-Eligible Beneficiaries from Medicaid to Medicare Drug Coverage

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit, known as Medicare Part D. The Centers for Medicare & Medicaid Services (CMS) is responsible for implementing this benefit. This new drug coverage will be provided through competing private Part D plans sponsored by health care organizations, which may charge premi… more
Date: December 16, 2005
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Text
Partner: UNT Libraries Government Documents Department
open access

Medicare: Advisory Opinions as a Means of Clarifying Program Requirements

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Health care providers are concerned about the quality of Medicare guidance issued by the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS). Specifically, they have reported that (1) they receive unclear guidance on program requirements and (2) because policies and procedures change frequently, they may rely on obsolete guidance, resulting … more
Date: December 8, 2004
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
open access

Medicare and Medicaid: Consumer Protection Requirements Affecting Dual-Eligible Beneficiaries Vary across Programs, Payment Systems, and States

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Medicare and Medicaid consumer protection requirements vary across programs, payment systems--either fee-for-service (FFS) or managed care--and states. Within Medicare, enrollment in managed care through the Medicare Advantage (MA) program must always be voluntary, whereas state Medicaid programs can require enrollment in managed care in certain situations. For example, Arizona requires nearly all benef… more
Date: December 5, 2012
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
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Medicare Advantage: Special Needs Plans Were More Profitable, on Average, than Plans Available to All Beneficiaries in 2011

Description: Correspondence issued by the Government Accountability Office with an abstract that begins "Special needs plans (SNP) reported having higher profit margins and spending a lower percentage of total revenues on medical expenses, on average, than Medicare Advantage (MA) plans available to all beneficiaries in 2011. For instance, SNPs' average profit margin was 4.0 percentage points higher than plans available to all beneficiaries--8.6 percent vs. 4.6 percent. SNPs also had a higher plan-level medi… more
Date: December 19, 2013
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Text
Partner: UNT Libraries Government Documents Department
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Medicare Part D: Opportunities Exist for Improving Information Sent to Enrollees and Scheduling the Annual Election Period

Description: A letter report issued by the Government Accountability Office with an abstract that begins "In Medicare Part D, enrollees in stand-alone prescription drug plans (PDPs) are allowed to switch plans during an annual coordinated election period (AEP) set under law from November 15 to December 31, with new coverage effective January 1. The Centers for Medicare & Medicaid Services (CMS) required that plan sponsors send an Annual Notice of Change (ANOC)--using either its model or a nonmodel format--b… more
Date: December 12, 2008
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
open access

Medicare Managed Care: Observations about Medicare Cost Plans

Description: A letter report issued by the Government Accountability Office with an abstract that begins "Medicare cost plans--managed care plans paid based on the reasonable costs of delivering Medicare-covered services--enroll a small number of beneficiaries compared to Medicare Advantage (MA), Medicare's managed care program in which the plans accept financial risk if their costs exceed fixed payments received for each enrolled beneficiary. Despite the small enrollment, industry representatives stated th… more
Date: December 28, 2009
Creator: United States. Government Accountability Office.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
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Medicare: Reporting on the Health Care Fraud and Abuse Control Program for Fiscal Years 1998 and 1999

Description: Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a legislative requirement, GAO reviewed the Health Care Fraud and Abuse Control (HCFAC) program, focusing on : (1) the amounts deposited to the Federal Hospital Insurance Trust Fund pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the sources of such amounts; (2) the amounts appropriated from the trust fund for HCFAC program and the justification for the expend… more
Date: December 13, 1999
Creator: United States. General Accounting Office.
Item Type: Refine your search to only Text
Partner: UNT Libraries Government Documents Department
open access

Medicare Temporary Payment Adjustments for Ground Ambulance Scheduled to Expire

Description: This report discusses the Medicare program which allows for adjustments in payment for ambulances due to the location of the service and level of service provided. A chart is provided showing the number of zip-codes in urban, rural, and super-rural areas for each state and territory.
Date: December 8, 2017
Creator: Villagrana, Marco A.
Item Type: Refine your search to only Report
Partner: UNT Libraries Government Documents Department
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