GAO Report Examines Hospice Disposal of Controlled Substances

A new Government Accountability Office (GAO) report on disposal of controlled substances found substantial challenges for hospices, but also some key best practices that point the way toward new industry standards. According to the GAO report, challenges include the costs of certain disposal methods, a lack of a witness to the disposal process, and inconsistencies…

GAO Report Recommends CMS Receive More Authority to Enforce Safety Requirements on Hospice

GAO report compares non-profit and for-profit hospices In recent months several reports examining aspects of the Medicare hospice benefit have been issued by oversight bodies including the Health and Human Services’ Office of the Inspector General (OIG) (previous coverage available HERE and HERE).  Most recently (November 14, 2019), the Government Accountability Office (GAO) released a…

The Challenges States Face to Promote Advanced Care Planning

Efforts by the various states to promote advanced care planning vary widely in their techniques and success, often leading to confusion for patients and access problems for clinicians, according to a new study by the Government Accountability Office (GAO). An advance care directive is a written instruction recognized under state law and relating to the…

CMS Chief: Prior Authorization Needed to Fight “Fraud and Abuse”

CMS Administrator Seema Verma complained that the federal government needs more legal authority to conduct Medicare prior authorization reviews she says work well in the private sector during a speech to the America’s Health Insurance Plans 2018 National Conference on Medicare on Tuesday, October 16. Interestingly, according to a report from Inside Health Policy, Barbara…

GAO: State Medicaid Home-and-Community-Based Services Face Funding and Workforce Challenges

States struggle to provide home-and-community-based services through their Medicaid programs due to workforce issues related to low pay, the complex needs of many patients, and limited funds from state governments, according to a new report from the Government Accountability Office (GAO). All state Medicaid programs provide some financial support for long-term services and supports (LTSS)…

Report: Improvements Needed to Prevent Medicaid Managed Care Payment Risks

The Centers for Medicare & Medicaid (CMS) should require states to report and document the amount of overpayments by managed care organizations to providers in order to eliminate improper payments, according to a new study from the Government Accountability Office (GAO). Under this Medicaid model, states pay a set periodic amount to MCOs for each beneficiary and…

CMS Plans to Bring Back Pre-Claim Review

The Centers for Medicare & Medicaid Services (CMS) plans to bring back an altered version of the pre-claim review (PCR) demonstration that was halted at the end of March 2017 after it was revealed that it found mere paperwork errors instead of the fraud that it was intended to uncover, according to May 29 offer…

GAO Calls for CMS to Resume Prior Authorization Experiment

A new report from the Government Accountability Office (GAO) calls on the Centers for Medicare & Medicaid Services (CMS) to resume or extend prior authorization experiments that have either been halted or are due to end soon. CMS began using prior authorization programs in September 2012 to ensure Medicare coverage and payment rules were met…