Saving Medicare: Lessons from the Private Sector : Hearings Before the Committee on the Budget, House of Representatives, One Hundred Fourth Congress, First Session, Hearings Held in Washington, DC, March 21 and 22, 1995, Volume 4

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U.S. Government Printing Office, 1995 - 190 pages

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Page 161 - Again, thank you for the opportunity to appear before you today. I would be happy to respond to any questions you might have.
Page 153 - JUNE GIBBS BROWN, INSPECTOR GENERAL, DEPARTMENT OF HEALTH AND HUMAN SERVICES Good morning.
Page 153 - OIG also generated savings, fines, restitutions, penalties, and receivables of over $8 billion. This represents $80 in savings for each Federal dollar invested in our office, or $6.4 million in savings per OIG employee. The Medicare program is administered by the Health Care Financing Administration (HCFA). Medicare Part A covers hospital and other institutional care for approximately 37 million persons age 65 or older and for certain disabled persons.
Page 153 - DEPARTMENT OF HEALTH AND HUMAN SERVICES BEFORE THE SUBCOMMITTEE ON HUMAN RESOURCES AND INTERGOVERNMENTAL RELATIONS COMMITTEE ON GOVERNMENT OPERATIONS US HOUSE OF REPRESENTATIVES JUNE 4, 1992 FOR RELEASE ONLY UPON DELIVERY Good Morning Mr.
Page 67 - This is due to coverage and improved access to preventive care under comprehensive HMO coverage which was also highlighted in a study by the Center for Disease Control and Prevention (CDC) and the National Center for Health Statistics.3 The CDC study showed that women in HMO's are more likely to obtain mammograms, pap smears and clinical breast exams than those in the fee-for-service sector.
Page 160 - Inadequate resources are available to address the problem of health care fraud and abuse. When Willie Sutton was asked why he robbed banks, he responded: "Because that's where the money is.
Page 90 - The committee met, pursuant to call, at 10:05 am in room 210, Cannon House Office Building, Hon. John R. Kasich [chairman of the committee] presiding. Present: Representatives...
Page 95 - ... this is the most important research conducted yet on health care costs because it explains the reason for the rapid growth in health care costs in the United States. The second factor contributing to rapid growth in health care costs is fee-for-service medicine. This factor interacts with third party payments to allow for unlimited increases in the volume and intensity of services provided to patients, without regard for the efficacy or cost effectiveness of those services. During the entire...
Page 102 - While these projections of future costs reflect an impossibility scenario, they still demonstrate the substantial size of Medicare benefits from a lifetime perspective. When both Social Security and Medicare benefits are counted together, the lifetime value of benefits approaches $1/2 million for an average-wage couple retiring today. Excluding inflation, the total is scheduled to exceed $1 million for some high—income couples retiring a few decades into the future. ARE WE GETTING OUR MONEY'S WORTH?...
Page 157 - Roughly $57 million in total enteral nutrition charges were allowed in both 1991 and 1992 under Part B when much of those costs should have been billed to Part A. It is clear that under Part A, patients' dietary needs should be covered by the SNF daily rate. Enteral nutrition is a liquid dietary substitute for patients who cannot survive on oral feedings. As much as $55 million in 1992 were charged to Part B for rehabilitation therapy. Rather than the SNF providing the ancillary services and charging...

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