U.S. Government Accountability Office Archives - Safety-Net Association of Pennsylvania

GAO Looks at Supplemental Medicaid Payments

Following up its own 2012 report that identified more than 500 hospitals receiving supplemental Medicaid payments that resulted in Medicaid payment surpluses, the U.S. Government Accountability Office has taken a broader look at supplemental payments state Medicaid programs make to hospitals and how those payments are used.
In a limited study of hospitals in four states, GAO found that some hospitals used supplemental payments for purposes other than serving Medicaid patients and the uninsured – purposes such as ordinary operations, capital purchases, a poison control center, even a helicopter. GAO also found that hospitals were more likely to receive such payments if local funding was used to draw down federal Medicaid matching funds. In some places, hospitals with local governments willing to finance the payments were more likely to receive them than hospitals located in places without such local support.
The GAO recommended that the Centers for Medicare & Medicaid Services take stronger steps to ensure that supplemental Medicaid payments are linked to the provision of Medicaid services and that CMS not permit states to make those payments contingent on local financing.
Learn more about why the GAO looked at supplemental Medicaid payments, what it learned, and what it recommended in the report Federal Guidance Needed to Address Concerns About Distribution of Supplemental Payments.

PA Safety Net Admin2016-03-09T06:00:15+00:00March 9th, 2016|Uncategorized|Comments Off

GAO Suggests Changes in Federal Medicaid Funding Formula

The U.S. Government Accountability Office has recommended changes in how the federal government matches state Medicaid funding for its share of overall Medicaid spending.
In testimony submitted to the House Energy and Commerce Committee’s Health Subcommittee, GAO reminded Congress that in the past

…GAO has examined multiple concerns regarding how the FMAP [federal medical assistance formula] allocates funds among states, including during times of economic downturn, and has suggested improvements.

In particular, the GAO is concerned about how the FMAP formula’s use of per capita income in targeting federal Medicaid matching funds may not accurate reflect economic conditions at the state level, especially during economic downturns, and fail to respond to states’ individual needs during those downturns.
In response to these concerns, the GAO suggested

…that Congress could consider an FMAP formula that targets variable state Medicaid needs and provides automatic, timely, and temporary assistance in response to national economic downturns.

For a closer look at what the GAO investigated, what it concluded, and what it recommended to Congress, go here to see the GAO report Medicaid: Changes to Funding Formula Could Improve Allocation of Funds to States.

PA Safety Net Admin2016-02-18T06:00:32+00:00February 18th, 2016|Uncategorized|Comments Off

GAO: More Information Needed About Supplemental Medicaid Payments

More data is needed about the supplemental Medicaid payments states make to hospitals and how those payments are financed, according to a new report from the U.S. Government Accountability Office (GAO).
According to the GAO, states are increasingly funding non-disproportionate share (Medicaid DSH) supplemental Medicaid payments to hospitals with funds from local governments and providers that are then matched by the federal government. In some states those supplemental payments, with the help of federal Medicaid matching funds, result in hospitals receiving reimbursement from Medicaid that exceeds the cost of the care they provide to their Medicaid patients.
Pennsylvania’s safety-net hospitals receive a number of such supplemental Medicaid payments.
In response to this concern, the GAO has urged the Centers for Medicare & Medicaid Services (CMS) to collect more and better data about how states finance their Medicaid programs and to do more to ensure that accuracy of that data. For its part, CMS maintains that its current efforts are adequate.
Learn more about this issue from the GAO report Improving Transparency and Accountability of Supplemental Payments and State Financing Methods, which can be found here.

PA Safety Net Admin2015-11-13T06:00:33+00:00November 13th, 2015|Medicaid supplemental payments, Pennsylvania safety-net hospitals|Comments Off

GAO Looks at Behavioral Health Options

Access to behavioral health services can be a challenge for low-income adults, so the U.S. Government Accountability Office (GAO) recently looked into those challenges.
In a new report, the GAO examined how many low-income adults have behavioral health problems, where they can go to receive the care they need – including whether there are differences in those options depending on whether the state in which the reside has expanded its Medicaid program – how Medicaid expansion states are providing coverage for behavioral health for newly eligible beneficiaries, and how obtaining Medicaid coverage affects the ability of such individuals to get the care they seek.
Access to behavioral health care can be an especially major challenge in the low-income communities typically served by Pennsylvania’s safety-net hospitals.
Read about the GAO’s findings in the report Options for Low-Income Adults to Receive Treatment in Selected States, which you can find here.

PA Safety Net Admin2015-07-24T06:00:04+00:00July 24th, 2015|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

GAO Identifies Medicaid Challenges

As Medicaid marks its 50th anniversary, the U.S. Government Accountability Office (GAO) testified recently before the House Energy and Commerce Committee’s Health Subcommittee on the major challenges facing the program.
GAO’s testimony focused on four major issues:

access to care
transparency and oversight
program integrity
federal financing

The GAO concluded that it

…considers Medicaid a high-risk program due to its size, growth, diversity, and gaps in oversight…

See GAO’s complete testimony here.

PA Safety Net Admin2015-07-16T06:00:43+00:00July 16th, 2015|Uncategorized|Comments Off

GAO Examines Medicaid Section 1115 Waivers

The U.S. Department of Health and Human Services (HHS) frequently exercises the authority granted to it under section 1115 of the Social Security Act to authorize Medicaid expenditures for uses not strictly permitted under that law if those uses extend Medicaid coverage to populations not already served by Medicaid or promote Medicaid objectives.
Pennsylvania’s Medicaid program has long taken advantage of section 1115 waivers.
At the request of the chairmen of the Senate Finance Committee and the House Energy and Commerce Committee, the U.S. Government Accountability Office (GAO) examined recently approved section 1115 waivers to evaluate whether those waivers met the criteria for the exemptions and whether the documents HHS issues when approving those waiver requests adequately convey what the approved expenditures are for and how they will promote Medicaid’s objectives.
As part of its investigation, GAO reviewed waiver requests from 25 states covering 150 programs and found that HHS lacked formal, written criteria for waivers and suggested that the agency more clearly express, in its approval documents, the objectives it expects programs to achieve in return for their exemption from some federal Medicaid requirements.
For a closer look at the study and its findings, see the report Medicaid Demonstrations: Approval Criteria and Documentation Need to Show How Spending Furthers Medicaid Objectives here, on the GAO web site.

PA Safety Net Admin2015-05-19T06:00:33+00:00May 19th, 2015|Pennsylvania Medicaid policy|Comments Off

GAO Reports on CHIP Extension

As a House-approved bill that would extend authorization for the Children’s Health Insurance Program (CHIP) for two years awaits Senate consideration, the U.S. Government Accountability Office (GAO) has issued a mandated evaluation of the program.
Among the GAO’s findings, it concluded that children enrolled in the program

… (1) had substantially better access to care, service use, and preventive care when compared with uninsured children; and (2) experienced comparable access and service use when compared with privately insured children.

It also found that nearly all children between the age of one and two enrolled in CHIP or Medicaid made at least one visit to a primary care physician in 2013; that the program’s costs for families were almost always less than states’ benchmark plans established under the Affordable Care Act; and that its benefits were generally comparable to those offered by benchmark plans.
For a closer look at the GAO report Children’s Health Insurance Program: Effects on Coverage and Access, and Considerations for Extending Fund, find links to a summary and the full report here, on the GAO web site.

PA Safety Net Admin2015-04-02T06:00:52+00:00April 2nd, 2015|Uncategorized|Comments Off

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