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Congressional Budget Office Cost Estimate: H.R. 6753: Strengthening the Health Care Fraud Prevention Task Force Act of 2018
"H.R. 6753 would amend the Social Security Act to establish a public-private partnership to detect and prevent health-care fraud. The Secretary of Health and Human Services would enter into a contract with a third party to carry out the duties of the partnership, including data analysis and sharing. A public-private partnership, including a contract with a third party, already exists to deter health-care fraud. Its membership includes several federal agencies, numerous state entities, and private firms. In CBO's [Congressional Budget Office] judgment, H.R. 6753 would codify existing agency practice and would have no budgetary effect. Enacting H.R. 6753 would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply. CBO estimates that enacting H.R. 6753 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2029."
United States. Congressional Budget Office
2018-10-09
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Congressional Budget Office Cost Estimate: H.R. 2061: Equitable Access to Care and Health Act
This is a Congressional Budget Office (CBO) cost estimate for H.R. 2061. "H.R. 2061 would expand the religious conscience exemption from the requirement that most people in the United States must obtain health insurance coverage or pay a penalty for not doing so (a provision of the Affordable Care Act known as the individual mandate). Specifically, the bill would newly exempt members of religious sects or divisions that do not meet the criteria for the religious conscience exemption under current law, but who rely solely on a religious method of healing and for whom the acceptance of medical health services would be inconsistent with their religious beliefs. On net, CBO and the staff of the Joint Committee on Taxation (JCT) estimate that enacting H.R. 2061 would increase federal deficits by $1.2 billion over the 2016-2025 period. That 10-year total consists of a $1.9 billion net reduction in revenues, primarily stemming from forgone penalties from uninsured individuals, partially offset by a $0.6 billion decrease in direct spending resulting from fewer people enrolling in Medicaid and subsidized health insurance coverage obtained through exchanges. The estimated reduction in revenues exceeds the estimated reduction in direct spending because CBO and JCT estimate that most of the people that would newly claim an exemption from the individual mandate under the bill are and will continue to be uninsured under current law."
United States. Congressional Budget Office
2015-09-25
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President Obama Announces the Creation of a Joint Virtual Lifetime Electronic Record [April 9, 2009]
"Today [April 9, 2009], the President, along with Secretary Gates and Secretary Shinseki, announced that the Department of Defense [DOD] and the Department of Veterans Affairs [VA] have taken the first step in creating a Joint Virtual Lifetime Electronic Record. Currently, there is no comprehensive system in place that allows for a streamlined transition of health care records between DOD and the VA. Both Departments will work together to define and build a system that will ultimately contain administrative and medical information from the day an individual enters military service throughout their military career, and after they leave the military. Access to electronic records is essential to modern health care delivery and the paperless administration of benefits. It provides a framework to ensure that all health care providers have all the information they need to deliver high-quality health care while reducing medical errors. The creation of this Joint Virtual Lifetime Record by the two organizations would take the next leap to delivering seamless, high-quality care, and serve as a model for the nation."
United States. Office of the White House Press Secretary
2009-04-09
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Executive Order 12751: Health Care Services for Operation Desert Storm
"By the authority vested in me as President by the Constitution and the laws of the United States of America, including the National Emergencies Act (50 U.S.C. 1601 'et seq'.), section 5011A of title 38 of the United States Code, and pursuant to the national emergency declared with respect to Iraq in Executive Order No. 12722 of August 2, 1990, it is hereby ordered that, in the event that the Department of Veterans Affairs Is requested by the Department of Defense to furnish care and services to members of the United States Armed Forces on active duty in Operation Desert Storm, the Secre· tary of Veterans Affairs may, pursuant to this order, enter into contracts with private facilities for the provision of hospital care and medical services for veterans to the fullest extent authorized by section 5011A(b)(1)-(2} of title 38 of the United States Code."
United States. Office of the Federal Register
Bush, George, 1924-
1991-02-14
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MMWR: Morbidity and Mortality Weekly Report: Surveillance Summaries, February 24, 2017
"This report summarizes 2014 BRFSS data from all 50 states and the District of Columbia on health care access and use of selected CPS recommended by the U.S. Preventive Services Task Force or the Advisory Committee on Immunization Practices among working-aged adults (aged 18-64 years), by state, state Medicaid expansion status, expanded geographic region, and federal poverty level (FPL). This report also provides analysis of primary type of health insurance coverage at the time of interview, continuity of health insurance coverage during the preceding 12 months, and other health care access measures (i.e., unmet health care need because of cost, unmet prescription need because of cost, medical debt [medical bills being paid off over time], number of health care visits during the preceding year, and satisfaction with received health care) from 43 states that included questions from the optional BRFSS Health Care Access module."
Centers for Disease Control and Prevention (U.S.)
2017-02-24
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Health Care Industry Cybersecurity Task Force: Report on Improving Cybersecurity in the Health Care Industry
"The health care system cannot deliver effective and safe care without deeper digital connectivity. If the health care system is connected, but insecure, this connectivity could betray patient safety, subjecting them to unnecessary risk and forcing them to pay unaffordable personal costs. Our nation must find a way to prevent our patients from being forced to choose between connectivity and security. In the Cybersecurity Act of 2015 (the Act), Congress established the Health Care Industry Cybersecurity (HCIC) Task Force to address the challenges the health care industry faces when securing and protecting itself against cybersecurity incidents, whether intentional or unintentional. Real cases of identity theft, ransomware, and targeted nation-state hacking prove that our health care data is vulnerable. Data collected for the good of patients and used to develop new treatments can be used for nefarious purposes such as fraud, identity theft, supply chain disruptions, the theft of research and development, and stock manipulation. Most importantly, cybersecurity attacks disrupt patient care (References to Figure 1 found below)."
Health Care Industry Cybersecurity Task Force
2017-06
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Hurricane Katrina: Federal Grants Have Helped Health Care Organizations Provide Primary Care, but Sustaining Services Will Be a Challenge, Statement of Cynthia A. Bascetta Director, Health Care, Testimony Before the Committee on Oversight and Government Reform, U.S. House of Representatives
"The greater New Orleans area--Jefferson, Orleans, Plaquemines, and St. Bernard parishes--continues to face challenges in restoring health care services disrupted by Hurricane Katrina which made landfall in August 2005. In 2007, the Department of Health and Human Services (HHS) awarded the $100 million Primary Care Access and Stabilization Grant (PCASG) to Louisiana to help restore primary care services to the low-income population. Louisiana gave PCASG funds to 25 outpatient provider organizations in the greater New Orleans area. GAO was asked to testify on (1) how PCASG fund recipients used the PCASG funds, (2) how recipients used and benefited from other federal hurricane relief funds, and (3) challenges recipients faced and recipients' plans for sustaining services after PCASG funds are no longer available. This statement is based on a recent GAO report, Hurricane Katrina: Federal Grants Have Helped Health Care Organizations Provide Primary Care, but Challenges Remain (GAO-09-588), other GAO work, and updated information on services, funding, and sustainability plans, which we shared with HHS officials. For the report, GAO analyzed responses to an October 2008 survey sent to all 25 PCASG fund recipients, to which 23 responded, and analyzed information related to other federal funds received by PCASG fund recipients. GAO also interviewed HHS and Louisiana Department of Health and Hospitals officials and other experts."
United States. Government Accountability Office
Bascetta, Cynthia A.
2009-12-03
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Veterans Health Care: Opportunities Remain to Improve Appointment Scheduling Within VA and Through Community Care, Statement of Debra A. Draper, Director, Health Care, Testimony Before the Committee on Veteran' Affairs, House of Representatives
From the Highlights: "The majority of veterans utilizing VA [Department of Veterans Affairs] health care services receive care in VA-operated medical facilities, including 172 VA medical centers and more than 1,000 outpatient facilities. For nearly 20 years, GAO [Government Accountability Office] has reported on the challenges VA medical facilities have faced providing health care services in a timely manner. When veterans face wait times at VA medical facilities, they may be able to receive services from VA's community care programs, which VA estimates will be 19 percent of its $86.5 billion in health care obligations in fiscal year 2020. This testimony focuses on GAO's large body of work on veterans' access to care and the status of VA's efforts to address GAO's recommendations, including those from GAO's June 2018 report on VA's community care programs and from GAO's December 2012 report on VA's scheduling of timely medical appointments that VA has provided information on through July 2019. It also includes preliminary observations on related ongoing work."
United States. Government Accountability Office
Draper, Debra A.
2019-07-24
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Severe Acute Respiratory Syndrome: Established Infectious Disease Control Measures Helped Contain Spread, but a Large-Scale Resurgence May Pose Challenges: Statement of Marjorie E. Kanof, Director, Health Care - Clinical and Military Health Care Issues: Testimony Before the Permanent Subcommittee on Investigations, Committee on Governmental Affairs
"Infectious disease experts emphasized that no new infectious disease control measures were introduced to contain SARS in the United States. Instead, strict compliance with and additional vigilance to enforce the use of current measures was sufficient. These measures--case identification and contact tracing, transmission control, and exposure management--are well established infectious disease control measures that proved effective in both health care and community settings. The combinations of measures that were used depended on either the prevalence of the disease in the community or the number of SARS patients served in a health care facility. For SARS, case identification within health care settings included screening individuals for fever, cough, and recent travel to a country with active cases of SARS. Contact tracing, the identification and tracking of individuals who had close contact with someone who was infected or suspected of being infected, was important for the identification and tracking of individuals at risk for SARS. Transmission control measures for SARS included contact precautions, especially hand washing after contact with someone who was ill, and protection against respiratory spread, including spread by large droplets and by smaller airborne particles. The use of isolation rooms with controlled airflow and the use of respiratory masks by health care workers were key elements of this approach. Exposure management practices-- isolation and quarantine--occurred in both health care and home settings. Effective communication among health care professionals and the general public reinforced the need to adhere to infectious disease control measures. While no one knows whether there will be a resurgence of SARS, federal, state, and local health care officials agree that it is necessary to prepare for the possibility. As part of these preparations, CDC, along with national associations representing state and local health officials, and others, is involved in developing both SARS-specific guidelines for using infectious disease control measures and contingency response plans. In addition, these associations have collaborated with CDC to develop a checklist of preparedness activities for state and local health officials. Such preparation efforts also improve the health care system's capacity to respond to other infectious disease outbreaks, including those precipitated by bioterrorism. However, implementing these plans during a large-scale outbreak may prove difficult due to limitations in both hospital and workforce capacity that could result in overcrowding, as well as potential shortages in health care workers and medical equipment--particularly respirators."
United States. General Accounting Office
Kanof, Marjorie E.
2003-07-30
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DOD Health Care: Domestic Health Care for Female Servicemembers, Report to Congressional Addressees
"Female servicemembers are serving in more complex occupational specialties and are being deployed to combat operations, potentially leading to increased health risks. Similar to their male counterparts, female servicemembers must maintain their medical readiness; however, they have unique health care needs that require access to gender-specific services. The National Defense Authorization Act for Fiscal Year 2012 directed GAO [Government Accountability Office] to review a variety of issues related to health care for female servicemembers. This report describes (1) the extent that DOD's [Department of Defense] policies for assessing individual medical readiness include unique health care issues of female servicemembers; (2) the availability of health care services to meet the unique needs of female servicemembers at domestic Army installations; and (3) the extent that DOD's research organizations have identified a need for research on the specific health care needs of female servicemembers who have served in combat. GAO reviewed DOD and military-service policies on individual medical readiness and surveyed senior health care officials about the availability of specific health services at the 27 domestic Army installations with MTFs [Military Treatment Facility] that report directly to the domestic regional medical commands. GAO focused on the Army because it has more female servicemembers than the other military services. GAO also visited six Army installations--two from each of the Army's three domestic regional medical commands--and interviewed DOD officials who conduct research on health issues for servicemembers."
United States. Government Accountability Office
2013-01
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Hearing on National Defense Authorization Act for Fiscal Year 2008 and Oversight of Previously Authorized Programs before the Committee on Armed Services, House of Representatives, One Hundred Tenth Congress, First Session, Military Personnel Subcommittee Hearing on Military Health-Care Budget and the Challenges Facing the Military Health-Care System, February 13, 2007
From the opening statement of Vic Snyder: "We appreciate you being here to testify on the Defense Health Care System budget and the challenges that it faces. As I have said in previous forums, rising health care costs is not something that is unique to the Department of Defense. Employers across the country are facing similar challenges in attempting to control the growth of health care costs for themselves and their employees. The question both the Department, Congress, and beneficiaries need to address is how do we approach this problem in a fair and equitable way that ensures we maintain a quality system that supports the military operational mission which is core to the system, while also continuing to provide quality care for DOD-eligible beneficiaries. In order for us to have an open and honest dialogue, we need to understand the challenges that the system faces and the opportunities that are available to address those challenges. Let me assure my colleagues and other interested parties that this will not be the only health care hearing that the subcommittee will hold. I expect that we will have several more through out the year, because this and other health related issues are not going to be solved by one hearing. There are enormous challenges facing the defense health care system-cost of health care is only one of many factors and increasing fees to beneficiaries may not necessarily be the most effective approach to solving this problem." Statements, letters, and materials submitted for the record include those of the following: John M. McHugh, Vic Snyder, William Winkenwerder, and Thelma Drake.
United States. Government Printing Office
2008
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Health-Care-Associated Infections in Hospitals: Leadership Needed from HHS to Prioritize Prevention Practices and Improve Data on These Infections, Statement of Cynthia A. Bascetta Director, Health Care, Testimony Before the Committee on Oversight and Government Reform, House of Representatives
"Disease Control and Prevention (CDC), health-care-associated infections (HAI)--infections that patients acquire while receiving treatment for other conditions--are estimated to be 1 of the top 10 causes of death in the nation. This statement summarizes a report issued in March and released today, Health-Care-Associated Infections in Hospitals: Leadership Needed from HHS to Prioritize Prevention Practices and Improve Data on These Infections (GAO-08-283). In this report, GAO examined (1) CDC's guidelines for hospitals to reduce or prevent HAIs and what HHS does to promote their implementation, (2) Centers for Medicare & Medicaid Services' (CMS) and hospital accrediting organizations' required standards for hospitals to reduce or prevent HAIs, and (3) HHS programs that collect data related to HAIs and integration of the data across HHS. To conduct the work, GAO reviewed documents and interviewed HHS agency and accrediting organization officials. In its report, GAO recommended that the Secretary of HHS identify priorities among the recommended practices in CDC's guidelines and establish greater consistency and compatibility of the data collected across HHS on HAIs. HHS generally agreed with GAO's recommendations. GAO also incorporated comments from the accrediting organizations as appropriate."
United States. Government Accountability Office
Bascetta, Cynthia A.
2008-04-16
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Roundtable on 'Crisis in the ER: How Can We Improve Emergency Medical Care?': Hearing Before the Subcommittee on Bioterrorism and Public Health Preparedness of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Ninth Congress, Second Session, on Examining Measures to Improve Emergency Medical Care, Focusing on the Need for Change to Continue Providing Quality Emergency Medical Care When and Where It is Expected, September 27, 2006
This is a roundtable on "Crisis in the ER--how can we improve emergency medical care?" from the hearing before the Subcommittee on Bioterrorism and Public Health Preparedness of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Ninth Congress, second session, on examining measures to improve emergency medical care, focusing on the need for change to continue providing quality emergency medical care when and where it is expected, on September 27, 2006.
United States. Government Printing Office
2006-09-27
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Veterans' Health Care: Limited Progress Made to Address Concerns That Led to High-Risk Designation, Statement of Debra A. Draper, Director, Health Care, Testimony Before the Committee on Veterans' Affairs, U.S. Senate
"VA [Department of Veterans Affairs] operates one of the largest health care delivery systems in the nation, including 168 medical centers and more than 1,000 outpatient facilities organized into regional networks. Enrollment in the VA health care system has grown significantly, from 7.9 million in fiscal year 2006 to almost 9 million in fiscal year 2016. Over that same period, VA's Veterans Health Administration's total budgetary resources have increased substantially, from $37.8 billion in fiscal year 2006 to $91.2 billion in fiscal year 2016. Since 1990, GAO [Government Accountability Office] has regularly updated the list of government operations that it has identified as high risk due to their vulnerability to fraud, waste, abuse, and mismanagement, or the need for transformation to address economy, efficiency, or effectiveness challenges. VA health care was added as a high-risk area in 2015 because of concerns about VA's ability to ensure the timeliness, cost-effectiveness, quality, and safety of veterans' health care. GAO assesses High-Risk List removal against five criteria: (1) leadership commitment, (2) capacity, (3) action plan, (4) monitoring, and (5) demonstrated progress. This statement, which is based on GAO's February 2017 high-risk report, addresses (1) actions VA has taken over the past 2 years to address the areas of concern that led GAO to designate VA health care as high risk, (2) the number of open GAO recommendations related to VA health care, and (3) additional actions VA needs to take to address the concerns that led to the high-risk designation."
United States. Government Accountability Office
Draper, Debra A.
2017-03-15
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Letter to Congressional Addressees from Randall B. Williamson, Director, Health Care, 'Defense Health Care: Oversight of Military Services' Post-Deployment Health Reassessment Completion Rates is Limited,' September 4, 2008
This letter from the GAO to several Congressional members discusses the lack of information provided by the Department of Defense relating to its post-deployment health assessment requirements, making it difficult for the GAO to evaluate the program accurately. "Military servicemembers engaged in combat tours in Afghanistan and Iraq are at risk of developing combat-related mental health conditions, including post-traumatic stress disorder (PTSD). In many cases, signs of potential mental health conditions do not surface until months after servicemembers return from deployment. In 2004, Army researchers published a series of articles that indicated a significant increase in the number of servicemembers reporting mental health concerns 90 to 120 days after returning from deployment, compared with mental health concerns reported before or soon after deployment. These findings led the Department of Defense (DOD) in March 2005 to develop requirements and policies for the post-deployment health reassessment (PDHRA) as part of its continuum of deployment health assessments for servicemembers. PDHRA is a screening tool for military servicemembers; it is designed to identify and address their health concerns--including mental health concerns--90 to 180 days after return from deployment. Servicemembers answer a set of questions about their physical and mental health conditions and concerns, and health care providers review the answers and refer servicemembers for further evaluation and treatment if necessary. A November 2007 study showed that a larger number of servicemembers indicated mental health concerns on their PDHRAs than on assessments earlier in their deployment cycles."
United States. Government Accountability Office
Williamson, Randall B.
2008-09-04
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VA Health Care: Reported Outpatient Medical Appointment Wait Times are Unreliable, Statement for the Record by Debra A. Draper, Director, Health Care, Statement for the Record to the Committee on Veterans' Affairs, U.S. House of Representatives
"I am pleased to have the opportunity to comment on overcoming barriers for quality mental health care for veterans--particularly those who are returning from deployment. In 2011, we reported that the number of veterans receiving mental health care had increased each year from fiscal year 2006 to 2010, and veterans who served in Afghanistan and Iraq accounted for an increasing proportion of veterans receiving mental health care during this period. We also reported on the key barriers that may hinder veterans from accessing mental health care from the Department of Veterans Affairs (VA), which included difficulty scheduling appointments. More recently, in December 2012, we reported on problems with VA's oversight of outpatient medical appointment scheduling processes and measurement of outpatient medical appointment wait times. In fiscal year 2011, there were more than 8 million veterans enrolled in VA's health system, which is operated by the Veterans Health Administration (VHA). VHA provided nearly 80 million outpatient medical appointments to veterans through its primary and specialty care clinics. Although access to timely medical appointments is critical to ensuring that veterans obtain needed medical care, long wait times and inadequate scheduling processes at VA medical centers (VAMC) have been long-standing problems that persist today."
United States. Government Accountability Office
2013-02-13
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S. Hrg. 115-326: The Potential for Health Care Savings Accounts to Engage Patients and Bend the Health Care Cost Curve, Hearing Before the Joint Economic Committee, Congress of the United States, One Hundred Fifteenth Congress, Second Session, June 7, 2018
This is the June 7, 2018 hearing on "The Potential for Health Care Savings Accounts to Engage Patients and Bend the Health Care Cost Curve," held before the U.S. Congress Joint Economic Committee. From the opening statement of Erik Paulsen: "All Americans deserve access to affordable patient-centered health care. Unfortunately, the fight to achieve this worthy goal has become politicized to the point where it is perilous to even acknowledge the shortcomings of our current Byzantine system. [...] We all acknowledge that American health care and health insurance are very expensive. And in today's hearing we will investigate how health savings accounts, or HSAs, allow Americans to lower the cost of health care by drawing on an important idea, an area of their expertise, and that's themselves." Statements, letters, and materials submitted for the record include those of the following: Scott W. Atlas, J. Kevin McKechnie, Tracy Watts, and Kavita Patel.
United States. Government Publishing Office
2018
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Child Welfare: Health Care Needs of Children in Foster Care and Related Federal Issues [November 19. 2014]
"Children who are placed in foster care are at a higher risk of having a medical, social, or behavioral disability than children in the general population. The abuse or neglect most experience before entering foster care can create physical and mental health issues, and the trauma of being removed from their parents may also incline children in foster care to social or behavioral health concerns. The Social Security Act addresses some of the health care needs of children in foster care-through provisions in titles pertaining to child welfare (Titles IV-B and IV-E) and those in the title pertaining to the Medicaid program (Title XIX). Federal child welfare policy expects state child welfare agencies to maintain health care records of children in foster care and to develop a strategy that addresses the health care needs of each child. States must provide Medicaid coverage to children who are eligible for the Title IV-E federal foster care program or, if applicable, eligible through other Medicaid eligibility pathways. […] This report begins with a discussion of major findings. It then briefly describes the foster care population and their unique health-related issues. Next is an overview of the federal programs and policies in three areas-child welfare, Medicaid, and private health insurance-that directly or indirectly address some of the health care needs of such children and young adults"
Library of Congress. Congressional Research Service
Fernandez, Bernadette; Fernandes-Alcantara, Adrienne L.; Baumrucker, Evelyne P. . . .
2014-11-19
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Association of Health Care Journalists [website]
This is the website of The Association of Health Care Journalists and provides information and relevant content for journalists covering health care topics. "The Association of Health Care Journalists is an independent, nonprofit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy and visibility of health care reporting, writing and editing. There are more than 1,000 members of AHCJ. [...]. The Association of Health Care Journalists, Inc. is an independent, nonprofit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy and visibility of health care reporting, writing and editing. AHCJ is classified as a 501(c)(6), a nonprofit professional trade association. Goals: To support the highest standards of reporting, writing, editing, and broadcasting in health care journalism for the general public and trade publications. To develop a strong and vibrant community of journalists concerned with all forms of health care journalism. To raise the stature of health care journalism in newsrooms, the industry, and the public, as a whole. To promote understanding between journalists and sources of news about how each can best serve the public. To advocate for the free flow of information to the public. To advocate for the improvement of professional development opportunities for journalists who cover any aspect of health and health care."
Association of Health Care Journalists
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Health Care: Constitutional Rights and Legislative Powers [March 23, 2012]
"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 or health care as a moral, legal, or constitutional right. It may be useful to distinguish between a right to health and a right to health care. An often cited definition of 'health' from the World Health Organization describes health as 'a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.' 'Health care' connotes the means for the achievement of health, as in the 'care, services or supplies related to the health of an individual.' For purposes of this report, discussion will be limited to constitutional and legal issues pertaining to a right to health care. Numerous questions arise concerning the parameters of a 'right to health care.' If each individual has a right to health care, how much care does a person have a right to and from whom? Would equality of access be a component of such a right? Do federal or state governments have a duty to provide health care services to the large numbers of medically uninsured persons? What kind of health care system would fulfill a duty to provide health care? How should this duty be enforced? The debate on these and other questions may be informed by a summary of the scope of the right to health care, particularly the right to access health care paid for by the government, under the U.S. Constitution, and under interpretations of the U.S. Supreme Court."
Library of Congress. Congressional Research Service
Swendiman, Kathleen S.
2012-03-23
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Department of Homeland Security: Organizational Structure, Spending, and Staffing for the Health Care Provided to Immigration Detainees, Statement of Alicia Puente Cackley, Director of Health Care, Testimony before the Subcommittee on Homeland Security, Committee on Appropriations, House of Representatives
From the text of the testimony of Alicia Puente Cackley: "I am pleased to be here today as you examine issues related to the health care provided to detainees held by U.S. Immigration and Customs Enforcement (ICE), a component of the Department of Homeland Security (DHS). For fiscal year 2004 through fiscal year 2007, ICE reported that 69 detainees died while in ICE custody, and during 2008, national news organizations investigated and published reports of the circumstances surrounding several detainee deaths. Other reports have also outlined concerns about the health care provided to detainees. For example, in 2007, the DHS Office of the Inspector General found problems with adherence to ICE's medical standards at two ICE facilities it reviewed where detainee deaths had occurred. Additionally, members of the Congress, the media, and advocacy groups have raised questions about the health care provided to detainees in ICE custody. An explanatory statement accompanying the fiscal year 2009 DHS appropriations act directed ICE to fund an independent, comprehensive review of the medical care provided to persons detained by DHS and identified $2 million for that purpose. My remarks today are based on our report, released at this hearing, entitled DHS: Organizational Structure and Resources for Providing Health Care to Immigration Detainees."
United States. Government Accountability Office
Puente Cackley, Alicia
2009-03-03
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VA Health Care: Actions Needed to Ensure Provider Qualifications and Competence, Statement of Sharon M. Silas, Director Health Care, Testimony Before the Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, House of Representatives
From the Highlights: "Nearly 165,000 licensed health care providers, such as physicians and nurses, provide care in VHA's [Veterans Health Administration] VA [Department of Veterans Affairs] medical centers and outpatient facilities. Medical center staff must determine whether to hire and retain health care providers by reviewing and verifying information about their qualifications and practice history. [...] Medical center staff must also investigate any concerns that arise about the clinical care their providers deliver. Depending on the findings from these reviews, medical centers may take an adverse privileging action against a provider. [...] This testimony is primarily based on GAO's [Government Accountability Office] 2019 and 2017 reports on VHA processes for reviewing and reporting quality and safety concerns about VA providers. It addresses VA medical centers' implementation and VHA's oversight of (1) reviews of adverse information about providers in the NPDB [National Practitioner Data Bank]; (2) reviews of providers' clinical care after concerns are raised; and (3) reporting of providers to the NPDB and state licensing boards."
United States. Government Accountability Office
Silas, Sharon M.
2019-10-16
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VA Health Care: Challenges in Budget Formulation and Execution, Statement of Randall B. Williamson, Director, Health Care, Testimony before the Subcommittee on Military Construction, Veteran Affairs, and Related Agencies, Committee on Appropriations, House of Representatives, March 12, 2009
This statement of Randall B. Williamson, Director, Health Care, before the Subcommittee on Military Construction, Veteran Affairs, and Related Agencies, House Committee on Appropriations was held on March 12, 2009. This testimony discusses the Department of Veterans Affairs'(VA) health care programs and considers the President's budget request for fiscal year 2010. "These programs form one of the largest health care delivery systems in the nation and provide, for eligible veterans, a range of services, including preventive and primary health care, outpatient and inpatient services, and prescription drugs."
United States. Government Accountability Office
2009-03-12
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Coast Guard Retiree Health Care: Coast Guard Contributions to and Payments from the DOD Medicare-Eligible Retiree Health Care Fund (MERHCF): Briefing for Staff of the House and Senate Subcommittees on Homeland Security, Committees on Appropriations
"This letter formally transmits the enclosed briefing slides in response to 154 Cong. Rec. H9801 (daily ed. Sept. 24, 2008) (Explanatory Statement accompanying H.R. 2638, Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009, Pub. L. No. 110-329, 122 Stat. 3574 (Sept. 30, 2008)). The briefing slides provide information about the process used to determine the amount charged to the Coast Guard for Medicare-eligible retiree health care and amounts paid from the MERHCF for health care benefits provided to Coast Guard retirees for fiscal years 2006 through 2008. […]. We performed this work in response to a mandate related to the Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009, Pub. L. No. 110-329, 122 Stat. 3574 (Sept. 30, 2008).Our objectives were the following: 1.Describe the process for determining Coast Guard's annual contribution into the MERHCF [Medicare-Eligible Retiree Health Care Fund]and report the amounts contributed during fiscal years 2006 through 2009. 2.Report the amounts paid from the MERHCF for health care benefits provided to Coast Guard Medicare-eligible retirees for fiscal years 2006 through 2008, the last year for which data is available."
United States. Government Accountability Office
2009-06-30
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GAO's 2013 High-Risk Update: Medicare and Medicaid; Statement of Kathleen M. King, Director, Health Care and Carolyn L. Yocom, Director, Health Care; Testimony Before the Subcommittee on Health, Committee on Energy and Commerce, House of Representatives
"In 2012, the Medicare program covered more than 49 million elderly and disabled beneficiaries at an estimated cost of $555 billion, and reported improper payments estimated to be more than $44 billion. The Centers for Medicare & Medicaid Services (CMS), which administers Medicare for the Department of Health and Human Services (HHS), is responsible for implementing payment methods that encourage efficient service delivery, managing Medicare to provide efficient and cost-effective services to beneficiaries, safeguarding the program from loss, and overseeing patient safety and care. Like health care spending in general, Medicare spending has grown faster than growth in the economy for many years. In the coming years, continued growth in the number of Medicare beneficiaries and program spending will create increasing challenges for the federal government."
United States. Government Accountability Office
2013-02-27
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Hospital Emergency Departments: Health Center Strategies that May Help Reduce Their Use, Statement of Debra A. Draper, Director, Health Care, Testimony Before the Subcommittee on Primary Health and Aging, Committee on Health, Education, Labor, and Pensions, U.S. Senate
"In brief, our work found that health centers have implemented three types of strategies that may help reduce emergency department use. These strategies focus on (1) emergency department diversion, (2) care coordination, and (3) accessibility of services. For example, some health centers have collaborated with hospitals to divert emergency department patients by educating them on the appropriate use of the emergency department and the services offered at the health center. Additionally, by improving care coordination for their patients, health centers may help reduce emergency department visits by encouraging patients to first seek care at the health center and by reducing, if not preventing, disease-related emergencies from occurring. Finally, health centers employed various strategies to increase the accessibility of their services, such as offering evening and weekend hours and providing same-day or walk-in appointments--which help position the health center as a convenient and viable alternative to the emergency department."
United States. Government Accountability Office
Draper, Debra A.
2011-05-11
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TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (ACA) [January 27, 2012]
"The 111th Congress passed, and the President signed into law, the Patient Protection and Affordable Care Act (P.L. 111-148; ACA), as amended by the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152; HCERA), and hereafter referred to as ACA. In general, ACA did not make any significant changes to the Department of Defense (DOD) TRICARE program or to the Department of Veterans Affairs (VA) health care system. However, many have sought clarification as to whether certain provisions in ACA, such as a mandate for most individuals to have health insurance, or extending dependant coverage up to age 26, would apply to TRICARE and VA health care beneficiaries. To address some of these concerns, Congress has introduced and/or enacted legislation. The TRICARE Affirmation Act (H.R. 4887; P.L. 111-159), signed into law on April 26, 2010, affirms that TRICARE satisfies the minimum acceptable coverage requirement in ACA. Similarly, P.L. 111-173, signed into law on May 27, 2010, clarifies that the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), Spina Bifida Health Care Program, and the Children of Women Vietnam Veterans Health Care Program meet the 'minimum essential coverage' requirement under ACA. TRICARE coverage of children was extended to age 26 by the Ike Skelton National Defense Authorization Act for Fiscal Year 2011 (P.L. 111-383). ACA requires that if a health insurance plan provides for dependent coverage of children, the plan must continue to make such coverage available for an adult child until age 26. This requirement relating to coverage of adult children will take effect for the plan years beginning on or after September 23, 2010. Under ACA, both married and unmarried children will qualify for this coverage. The authorizing statute for CHAMPVA currently does not conform to this ACA requirement."
Library of Congress. Congressional Research Service
Panangala, Sidath Viranga; Jansen, Don J.
2012-01-27
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TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (ACA) [February 11, 2014]
"The 111th Congress passed, and the President signed into law, the Patient Protection and Affordable Care Act (P.L. 111-148; ACA), which was later amended by the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152; HCERA), and is hereinafter referred to as ACA. In general, ACA did not make any significant changes to the Department of Defense (DOD) TRICARE program or to the Department of Veterans Affairs (VA) health care system. However, many have sought clarification as to whether certain provisions in ACA, such as a mandate for most individuals to have health insurance, or extending dependent coverage up to age 26, would apply to TRICARE and VA health care beneficiaries. To address some of these concerns, Congress has introduced and/or enacted legislation. The TRICARE Affirmation Act (P.L. 111-159), signed into law on April 26, 2010, affirms that TRICARE satisfies the minimum essential coverage requirement in ACA. Similarly, P.L. 111- 173, signed into law on May 27, 2010, clarifies that the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), Spina Bifida Health Care Program, and the Children of Women Vietnam Veterans Health Care Program meet the 'minimum essential coverage' requirement under ACA. TRICARE coverage of children was extended to age 26 by the Ike Skelton National Defense Authorization Act for Fiscal Year 2011 (P.L. 111-383)."
Library of Congress. Congressional Research Service
Panangala, Sidath Viranga; Jansen, Don J.
2014-02-11
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VA Health Care: Management and Oversight of Fee Basis Care Need Improvement, Report to Congressional Requesters
"While VA [Department of Veterans Affairs] treats the majority of veterans in VA-operated facilities, in some instances it must obtain the services of non-VA providers to ensure that veterans are provided timely and accessible care. These non-VA providers are commonly reimbursed by VA using a fee-for-service arrangement known as fee basis care. VA's fee basis care program has grown rapidly in recent years--rising from about 8 percent of VA's total health care services budget in fiscal year 2005 to about 11 percent in fiscal year 2012. GAO [Government Accountability Office] was asked to review fee basis care program spending and utilization and factors that influence VAMC [Veterans Affairs Medical Centers] fee basis utilization. This report examines how fee basis care spending and utilization changed from fiscal year 2008 to fiscal year 2012, factors that contribute to the use of fee basis care, and VA's oversight of fee basis care program spending and utilization. GAO reviewed relevant laws and regulations, VA policies, and fee basis spending and utilization data from fiscal year 2008 through fiscal year 2012. In addition, GAO reviewed the fee basis care operations of six selected VAMCs that varied in size, services offered, and geographic location. […] GAO recommends that VA revise its beneficiary travel regulations to allow reimbursement for veterans seeking similar care from a fee basis provider, apply the same wait time goals to fee basis care as VAMC-based care, and ensure fee basis data includes a claim number. VA generally concurred with GAO's conclusions and five recommendations."
United States. Government Accountability Office
2013-05
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S. Hrg. 109-611: Lessons Learned from Katrina in Public Health Care, Hearing Before the Subcommittee on Bioterrorism and Public Health Preparedness of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Ninth Congress, Second Session, on Examining Legislative Improvements to Ensure Our Nation is Better Prepared for Public Health Emergencies, July 14, 2006 (New Orleans, LA)
This is the July 14, 2006 hearing on "Lessons Learned from Katrina in Public Health," held before the U.S. Senate Committee on Health, Education, Labor, and Pensions. From the opening statement of Richard Burr: "One of the pressing issues that our public health and medical response system faces is our ability to increase our capacity to take care of people in large public health emergencies. We need to think systematically about how to develop surge capacity within our health care delivery system. We must also maintain a well-trained and well-prepared public health workforce. This is no small task since 45 percent of the current health workforce is eligible for retirement in the next 5 years." Statements, letters, and materials submitted for the record include those of the following: Fred Cerise, Sharon Howard, Don Smithburg, Janice Latourneau, Paul K. Whelton, Patrick J. Quinlan, Jeffrey Rouse, Gery Barry.
United States. Government Printing Office
2007
