Health Care Fraud and Abuse: Hearing Before the Subcommittee on Human Resources and Intergovernmental Relations of the Committee on Government Reform and Oversight House of Representatives, One Hundred Fourth Congress, First on H.R. 1850 ... H.R. 2326 ... September 28, 1995 |
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Abuse Control Administration agencies anti-fraud Attorney beneficiaries Chairman Christopher Shays claims committee Congress Control Account Control Unit cost Crawford Grayling criminal Department EDOLPHUS TOWNS ERISA established Family/General Practice Federal health Feehan FQHCS fraud and abuse funds goals going HCFA health care clinics health care fraud health care programs Health Clinic program Health Service Corps hearing hospital Houghton Lake HPSA HRSA improve access Inspector investigations issue law enforcement legislation look MD Internal Medicaid Fraud Medicaid programs Medicare and Medicaid Merced million National Health Service Newaygo County Office patients payment percent physician assistants population practitioners primary private payers problem prosecution providers reimbursement RHC program Roscommon rural health clinic SCHIFF SHAYS shortage areas shortage designations SMITS SNOWBARGER statement STEINHARDT Subaccount Subcommittee subsection Thank Towns underserved areas United States Code
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Page 3 - Mr. Towns. Mr. TOWNS. Thank you very much, Mr. Chairman for holding this hearing.
Page 7 - I ask further unanimous consent that all witnesses be permitted to include their written statements in the record; and without objection, so ordered.
Page 20 - I would be pleased to respond to any questions you or members of the Subcommittee may have.
Page 4 - I want to thank you for holding today's hearing, and I look forward to hearing the testimony of all of the witnesses.
Page 13 - Medicaid more than $295 million a year4 to primarily subsidize care in cities and towns already having substantial health care resources. Our review of a sample of clinics showed that the availability of care did not change appreciably for at least 90 percent of Medicare and Medicaid beneficiaries using the clinics. Staff we interviewed at most clinics said they did not use the subsidies to expand access to underserved portions of the population or need the subsidies to remain financially...
Page 14 - In creating the federal Health Professional Shortage Area designation system, federal intervention was considered justified only if the number of health care providers was significantly less than adequate, indicating that the needs of these areas were not being met through free-market mechanisms or reimbursement programs.
Page 18 - ... managers can decide whether federal intervention has been successful and can GAO/T-HEHS-97-204 be discontinued, or if other strategies for addressing access barriers that still exist in communities would provide a more effective solution. Establishing Results-Oriented Performance Goals and Measures The Results Act provides an opportunity for HHS to make sure its access programs are on track and to identify how efforts under each program will fit within the broader access goals. The Results Act...
Page 15 - MUAs are designated based on a relative ranking of all US counties, minor civil divisions, and census tracts that occurred in 1975 and 1976. All areas that ranked below the county median combined score for the four criteria were designated as MUAs. MUAs have been added since then on the basis of newer data and the same cutoff score.
Page 11 - Today, we would like to discuss our findings in the broader context of our past reviews of federal efforts to improve access to primary health care. The federal government spends billions of dollars each year on programs like the Rural Health Clinic program that, in whole or part, are aimed at achieving this objective.