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Start Over Collections Health Policy and Services Research ✖Remove constraint Collections: Health Policy and Services Research Subjects United States ✖Remove constraint Subjects: United States Subjects Insurance, Health, Reimbursement ✖Remove constraint Subjects: Insurance, Health, Reimbursement Genre Technical Report ✖Remove constraint Genre: Technical Report Copyright Public domain ✖Remove constraint Copyright: Public domain

1. CMS validated hospital inpatient quality reporting program data, but should use additional tools to identify gaming

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, April 2017
Subject(s):
Economics, Hospital
Insurance, Health, Reimbursement
Quality Indicators, Health Care
Reimbursement, Incentive
Cross Infection
Inpatients
Mandatory Reporting
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

2. Round 2 competitive bidding for CPAP/RAD: disrupted access unlikely for devices, inconclusive for supplies

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, June 2017
Subject(s):
Competitive Bidding
Continuous Positive Airway Pressure -- economics
Continuous Positive Airway Pressure -- instrumentation
Durable Medical Equipment -- economics
Health Services Accessibility -- economics
Insurance Coverage -- economics
Insurance, Health, Reimbursement
Medicare -- economics
Respiration, Artificial -- economics
Respiration, Artificial -- instrumentation
Humans
United States
United States. Department of Health and Human Services.

4. Medicare Part B drug payments: impact of price substitutions based on 2014 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2017
Subject(s):
Drug Costs
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services
Medicare Part B -- economics
Cost Savings
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

5. Enhancements needed in the tracking and collection of Medicare overpayments identified by ZPICS and PSCS

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Financial Audit
Insurance, Health, Reimbursement
Medicare -- economics
Contract Services
Durable Medical Equipment -- economics
Home Care Services -- economics
Hospice Care -- economics
Information Dissemination
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

6. Medicare Part B drug payments: impact of price substitutions based on 2015 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Drug Costs
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services
Medicare -- economics
Cost Savings
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

7. Medicare payments for clinical diagnostic laboratory tests in 2016: year 3 of baseline data

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Clinical Laboratory Techniques -- economics
Insurance, Health, Reimbursement
Medicare Part B -- economics
Prospective Payment System
Rate Setting and Review
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

8. Followup review: CMS's management of the quality payment program

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, December 2017
Subject(s):
Insurance, Health, Reimbursement
Medical Informatics
Medicare Part B -- economics
Quality of Health Care -- economics
Reimbursement, Incentive
Diffusion of Innovation
Fraud -- prevention & control
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

9. Potential misclassifications reported by drug manufacturers may have led to $1 billion in lost Medicaid rebates

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, December 2017
Subject(s):
Drug Costs
Drug Industry -- economics
Medicaid -- economics
Pharmaceutical Preparations -- classification
Pharmaceutical Preparations -- economics
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

10. Round two competitive bidding for oxygen: continued access for vast majority of beneficiaries

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, May 2018
Subject(s):
Competitive Bidding
Durable Medical Equipment -- economics
Health Services Accessibility
Insurance, Health, Reimbursement
Medicare -- economics
Oxygen Inhalation Therapy -- economics
Fraud -- prevention & control
Humans
United States
United States. Department of Health and Human Services.

11. Round two competitive bidding for enteral nutrition: continued access for vast majority of beneficiaries

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, May 2018
Subject(s):
Competitive Bidding
Durable Medical Equipment -- economics
Enteral Nutrition -- economics
Health Services Accessibility
Insurance, Health, Reimbursement
Medicare -- economics
Fraud -- prevention & control
Humans
United States
United States. Department of Health and Human Services.

13. CMS did not detect some inappropriate claims for durable medical equipment in nursing facilities

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, June 2018
Subject(s):
Durable Medical Equipment -- economics
Insurance, Health, Reimbursement
Medicare -- economics
Skilled Nursing Facilities
Home Care Services -- economics
Insurance Claim Review
Insurance Coverage
Medicaid -- economics
Nursing Homes
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

14. Medicare Part B drug payments: impact of price substitutions based on 2016 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2018
Subject(s):
Drug Costs
Insurance, Health, Reimbursement
Medicare Part B -- economics
Cost Savings
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

15. Questionable billing for compounded topical drugs in Medicare Part D

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2018
Subject(s):
Dermatologic Agents -- economics
Dermatologic Agents -- therapeutic use
Drug Compounding -- economics
Drug Utilization -- trends
Fraud
Insurance, Health, Reimbursement
Medicare Part D -- economics
Skin Cream -- economics
Administration, Topical
Dermatologic Agents -- adverse effects
Drug Compounding -- standards
Forecasting
Health Expenditures -- trends
Insurance Coverage
Skin Cream -- adverse effects
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

16. Medicare payments for clinical diagnostic laboratory tests in 2017: year 4 of baseline data

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2018
Subject(s):
Clinical Laboratory Techniques -- economics
Insurance, Health, Reimbursement
Medicare Part B -- economics
Prospective Payment System
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

17. Medicare Advantage appeal outcomes and audit findings raise concerns about service and payment denials

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2018
Subject(s):
Health Services Accessibility
Insurance Claim Review -- statistics & numerical data
Insurance Coverage
Insurance, Health, Reimbursement
Medicare Part C
Financial Audit
Insurance Claim Review -- economics
Managed Care Programs
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

19. Key design components and considerations for establishing a single-payer health care system: testimony before the Committee on the Budget, United States House of Representatives

Publication:
[Washington, DC] : Congressional Budget Office, May 22, 2019
Subject(s):
Insurance, Health, Reimbursement
Single-Payer System -- organization & administration
Universal Health Insurance
Cost Sharing
Health Care Reform
Health Services Accessibility
Insurance Coverage
Insurance, Health -- organization & administration
Humans
United States

20. Projecting demand for the services of primary care doctors:

Author(s):
Duchovny, Noelia, author
Trachtman, Sam, author
Werble, Ellen, author
Publication:
Washington, D.C. : Congressional Budget Office, May 2017
Subject(s):
Health Services Needs and Demand -- statistics & numerical data
Physicians, Family -- supply & distribution
Primary Health Care -- statistics & numerical data
Primary Health Care -- trends
Federal Government
Forecasting
Health Manpower -- statistics & numerical data
Health Manpower -- trends
Health Policy
Health Services Needs and Demand -- trends
Insurance Coverage
Insurance, Health, Reimbursement
Medicaid
Medicare
Physicians, Family -- education
Population Dynamics
Population Growth
Telemedicine
Humans
United States

21. An analysis of private-sector prices for hospital admissions

Author(s):
Maeda, Jared Lane, author
Nelson, Lyle, author
Publication:
[Washington, D.C.] : Congressional Budget Office, April 2017
Subject(s):
Hospital Costs -- statistics & numerical data
Insurance, Health, Reimbursement
Medicare -- economics
Medicare Part C -- economics
Private Sector
Diagnosis-Related Groups
Fee-for-Service Plans -- economics
Health Expenditures -- statistics & numerical data
Reimbursement Mechanisms
Humans
United States

23. Medicare provider education: oversight of efforts to reduce improper billing needs improvement : report to the Chairman, Committee on Finance, U.S. Senate

Publication:
Washington, D.C. : U.S. Government Accountability Office, March 2017
Subject(s):
Accounts Payable and Receivable
Fraud -- prevention & control
Insurance Claim Review
Medicare -- economics
Contract Services
Insurance, Health, Reimbursement
Humans
United States
United States. Department of Health and Human Services
Centers for Medicare & Medicaid Services (U.S.)

24. Medicaid program integrity: CMS should build on current oversight efforts by further enhancing collaboration with states : report to the Chairman, Committee on Finance, U.S. Senate

Publication:
Washington, D.C. : U.S. Government Accountability Office, March 2017
Subject(s):
Financial Audit
Fraud -- prevention & control
Insurance, Health, Reimbursement
Medicaid -- economics
Program Evaluation
Contract Services
Managed Care Programs
State Government
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

25. Health care: telehealth and remote patient monitoring use in Medicare and selected federal programs : report to Congressional committees

Publication:
Washington, D.C. : U.S. Government Accountability Office, April 2017
Subject(s):
Health Services Accessibility
Medicare
Telemedicine
Telemetry
Insurance Coverage
Insurance, Health, Reimbursement
Medicaid
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

26. Medicaid personal care services: more harmonized program requirements and better data are needed : testimony before the Subcommittee on Oversight and Investigations, Committee on Energy and Commerce, House of Representatives

Publication:
Washington, D.C. : U.S. Government Accountability Office, May 2, 2017
Subject(s):
Fraud -- prevention & control
Community Health Services -- economics
Home Care Services -- economics
Insurance, Health, Reimbursement
Medicaid -- economics
Community Health Services -- organization & administration
Data Collection
Government Regulation
Health Expenditures
Home Care Services -- organization & administration
Quality Assurance, Health Care
State Government
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

27. Veterans Affairs: improper payment estimates and ongoing efforts for reduction : testimony before the Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, House of Representatives

Publication:
Washington, D.C. : U.S. Government Accountability Office, May 24, 2017
Subject(s):
Fraud -- prevention & control
Insurance, Disability
Insurance, Health, Reimbursement
Veterans Disability Claims
Veterans Health
Quality Assurance, Health Care
Humans
United States
United States. Department of Veterans Affairs.

29. Medicare: CMS should evaluate providing coverage for disposable medical devices that could substitute for durable medical equipment : report to Congressional committees

Publication:
Washington, D.C. : U.S. Government Accountability Office, July 2017
Subject(s):
Durable Medical Equipment -- economics
Equipment Reuse -- economics
Insurance Coverage -- economics
Insurance, Health, Reimbursement
Medicare -- economics
Blood Glucose Self-Monitoring -- instrumentation
Continuous Positive Airway Pressure -- instrumentation
Cost Savings
Infusion Pumps -- economics
Negative-Pressure Wound Therapy -- instrumentation
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

30. Drug discount program: update on agency efforts to improve 340B program oversight : testimony before the Subcommittee on Oversight and Investigations, Committee on Energy and Commerce, House of Representatives

Publication:
Washington, D.C. : U.S. Government Accountability Office, July 18, 2017
Subject(s):
Government Regulation
Insurance, Pharmaceutical Services -- economics
Medicaid -- economics
Contract Services
Economics, Pharmaceutical
Forecasting
Government Programs -- statistics & numerical data
Insurance, Health, Reimbursement
Pharmacies -- statistics & numerical data
Pharmacies -- trends
Humans
United States
United States. Health Resources and Services Administration.

31. Medicare Advantage program integrity: CMS's efforts to ensure proper payments and identify and recover improper payments : testimony before the Subcommittee on Oversight, Committee on Ways and Means, House of Representatives

Publication:
Washington, D.C. : U.S. Government Accountability Office, July 19, 2017
Subject(s):
Financial Audit
Fraud -- prevention & control
Insurance, Health, Reimbursement
Medicare Part C -- economics
Fee-for-Service Plans -- economics
Insurance Claim Review
Humans
United States
Centers for Medicare & Medicaid Services (U.S.)

32. Telehealth: use in Medicare and Medicaid : testimony before the Subcommittee on Agriculture, Energy, and Trade and Subcommittee on Health and Technology, Committee on Small Business, House of Representatives

Publication:
Washington, D.C. : U.S. Government Accountability Office, July 20, 2017
Subject(s):
Insurance Coverage
Insurance, Health, Reimbursement
Medicaid -- economics
Medicare -- economics
Telemedicine -- economics
Telemedicine -- utilization
Health Services Accessibility
Reimbursement Mechanisms
Rural Health Services
Rural Population
Humans
United States
Centers for Medicare & Medicaid Services (U.S.)

33. Medicare: CMS Fraud Prevention System uses claims analysis to address fraud : report to Congressional requesters

Publication:
Washington, D.C. : U.S. Government Accountability Office, August 2017
Subject(s):
Fraud -- prevention & control
Insurance Claim Review
Medicare
Public-Private Sector Partnerships
Contract Services
Data Interpretation, Statistical
Information Dissemination
Insurance, Health, Reimbursement
Humans
United States
Centers for Medicare & Medicaid Services (U.S.)

34. Medicare Part B: Medicare represented at least half of the market for 22 of the 84 most expensive drugs in 2015 : report to Congressional requesters

Publication:
Washington, DC : United States Government Accountability Office, December 2017
Subject(s):
Drug Costs
Health Care Sector
Health Expenditures
Medicare Part B -- economics
Insurance, Health, Reimbursement
Medicare Part B -- statistics & numerical data
Humans
United States

35. Billions in estimated Medicare Advantage payments from chart reviews raise concerns

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, December 2019
Subject(s):
Insurance, Health, Reimbursement
Medical Records -- economics
Medicare Part C -- economics
Quality of Health Care
Risk Adjustment
United States
United States. Department of Health and Human Services
Centers for Medicare & Medicaid Services (U.S.)

36. Data on Medicaid Managed Care payments to providers are incomplete and inaccurate

Publication:
Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, March 2021
Subject(s):
Economics, Medical -- statistics & numerical data
Government Regulation
Insurance, Health, Reimbursement
Managed Care Programs -- economics
Medicaid -- economics
United States
United States. Department of Health and Human Services

40. Medicare Part B drug payments: impact of price substitutions based on 2017 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2019
Subject(s):
Cost Control
Cost Savings
Drug Costs
Insurance, Health, Reimbursement
Medicare Part B -- economics
Reimbursement Mechanisms
Economics, Pharmaceutical
Humans
United States
Centers for Medicare & Medicaid Services (U.S.)

41. Labs with questionably high billing for additional tests alongside COVID-19 tests warrant further scrutiny

Author(s):
Maxwell, Ann, (Deputy Inspector General for Evaluation and Inspections), author
Publication:
Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, December 2022
Subject(s):
Clinical Laboratory Techniques -- economics
Costs and Cost Analysis
COVID-19 Testing -- economics
Insurance, Health, Reimbursement
Medicare Part B
United States

42. Private health insurance: Roll out of independent dispute resolution process for out-of-network claims has been challenging : report to congressional committees

Publication:
Washington, DC : United States Government Accountability Office, December 2023
Subject(s):
Dissent and Disputes
Government Regulation
Health Benefit Plans, Employee
Health Expenditures
Insurance Claim Review
Insurance, Health, Reimbursement
Negotiating
United States

43. The future of remote patient monitoring

Author(s):
Harris, Julia, (Of Bipartisan Policy Center), author
Curtis, Mikayla, author
Sandalow, Maya, author
Hoagland, G. William, author
Serafini, Marilyn, author
Publication:
Washington, DC : Bipartisan Policy Center, January 2024
Subject(s):
Computer Security
Electronic Health Records
Government Regulation
Health Equity
Health Policy
Insurance, Health, Reimbursement
Medicaid
Medical Device Legislation
Medicare
Remote Sensing Technology
Telemedicine
United States