Tag: GAO

WASHINGTON – Members of the Government Accountability Office testified before Congress last week saying, while Medicare beneficiaries and providers have benefitted from program waivers and other flexibilities, their continued use beyond the pandemic increases risks and raise considerations.  Among those risks and considerations:  Increased spending: Telehealth waivers can increase spending in both Medicare and Medicaid, if telehealth services are furnished in addition...

WASHINGTON - The average reduction in payment rates in non-competitive bidding areas for five DME items with the highest expenditures in 2016 was 46%, according to a new report from the Government Accountability Office.In its review of the effects of reduced payment rates in non-bid areas, the GAO also found that: the number of suppliers furnishing rate-adjusted items in non-bid areas in 2016 decreased 8% compared to 2015; and beneficiary utilization of rate-adjusted items in non-bid areas in 2016...

WASHINGTON - The Government Accountability Office has recommended that the Department of Health and Human Services evaluates the possible costs and savings of using disposable devices as substitutes for DME and, if appropriate, seek legislative authority to cover them.While Medicare generally doesn't cover disposable devices, the GAO identified eight such devices that could potentially substitute for DME devices that are covered. These disposable devices fall into existing Medicare DME categories:...

WASHINGTON - Concerns over payment and coverage restrictions are barriers to healthcare providers and patients using telehealth and remote patient monitoring to improve quality of care, according to a new study from the Government Accountability Office. An example of such a restriction, the GAO says: Medicare telehealth coverage limits the geographic and practice settings in which beneficiaries may receive these services. For the study, the GAO reviewed Medicare documents and regulations, and interviewed...

WASHINGTON - The number of Medicare beneficiaries receiving DMEPOS in Round 2 areas decreased more than twice as much from 2012 to 2014 than in non-bid areas, according to a new report from the Government Accountability Office.The number of beneficiaries receiving DMEPOS in Round 2 areas decreased 17% from 2012, the year before bid pricing went into effect, to 2014, the year after. The number of beneficiaries in non-bid areas decreased 6% during the same time period.“CMS officials stated that...

WASHINGTON - CMS needs to do a better job overseeing Medicaid managed care, the Government Accountability Office says in a report public released June 18.The GAO found that the program integrity units of five states and the Medicaid Fraud Control Units of seven states that were included in its review focus their efforts on Medicaid fee-for-service payments, not Medicaid managed care payments. This, the GAO points out, despite the fact that Medicaid managed care is growing at a faster rate than fee-for-service.Moreover,...

WASHINGTON - The Government Accountability Office (GAO) is calling on CMS to improve the efficiency and effectiveness of its post-payment review efforts by providing contractors with additional guidance and more oversight.The GAO reviewed MACs, ZPICs, RAs and CERT contractors because “questions have been raised about their effectiveness and efficiency, and the burden on providers.”While CMS has taken steps to prevent contractors from conducting duplicative post-payment claims reviews,...

WASHINGTON - The brief mention of repair issues in a recent Government Accountability Office (GAO) report on competitive bidding doesn't speak to the severity of the problem, say mobility stakeholders.“I think the GAO report brought some acknowledgement of the problems in the competitive bidding areas, but I think what we want to continue to focus on with CMS is that this is a broader problem requiring fixes not just in the competitive bidding program, but the Medicare program in general,”...

WASHINGTON - The number of both beneficiaries and DME suppliers declined in Round 1 competitive bidding program areas in 2012, according to a new report issued yesterday by the Government Accountability Office (GAO).To conduct its study, the GAO compared Medicare claims data from 2011 and 2012 with 2010 for beneficiaries; and compared claims data for 2012 with 2010 for contract and non-contract suppliers. For monitoring purposes, CMS had selected nine “comparator” areas that were demographically...

NEW YORK - The Government Accountability Office (GAO) has denied Rotech's protest that the Department of Veterans Affairs (VA) unreasonably ignored recent, relevant information when it decided Rotech wasn't financially fit to win contracts to supply veterans with home oxygen equipment, Law360 reports. The VA contended that Rotech, which entered Chapter 11 bankruptcy protection in April, didn't qualify as a “responsible contractor,” according to the story. The VA's contracting...