Download or read book Audits of Medicare Prescription Drug Plan Sponsors written by CreateSpace Independent Publishing Platform and published by Createspace Independent Publishing Platform. This book was released on 2018-07-03 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: Audits of Medicare prescription drug plan sponsors.
Download or read book Medicare Part D written by Kathleen M. King and published by DIANE Publishing. This book was released on 2009-02 with total page 43 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit, known as Medicare Part D. The Centers for Medicare and Medicaid Services (CMS) contracts with private companies to serve as Part D sponsors and administer the Part D prescription drug benefit plans. The MMA requires Part D sponsors to implement programs to control for fraud and abuse. This report examines: (1) the extent to which certain Part D sponsors have implemented programs to control fraud, waste, and abuse; and (2) the extent of CMS¿s oversight of Part D sponsors¿ programs to control fraud, waste, and abuse. Includes recommendations. Charts and tables.
Download or read book Medicare Part D Prescription Drug Coverage written by Jennifer R. Luong and published by DIANE Publishing. This book was released on 2010-03 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: The outpatient prescription drug benefit known as Medicare Part D was first available in Jan. 2006, and that year it provided federally subsidized prescription drug coverage for nearly 28 million beneficiaries at a cost of $47.4 billion -- almost 12% of total Medicare spending. Part D sponsors -- entities that enter into contracts with Medicare -- administer the benefit and compete for beneficiary enrollment. To provide coverage, the sponsors enter into contractual relationships with pharmacy benefit managers, drug manufacturers, and retail pharmacies. The Part D program relies on sponsors to generate prescription drug savings, in part through their ability to negotiate price concessions, such as rebates and discounts, with these entities.
Download or read book Medicare Part D written by Kathleen M. King and published by . This book was released on 2008-10 with total page 42 pages. Available in PDF, EPUB and Kindle. Book excerpt: Under the Medicare Part D program, prescription drug coverage is provided through plans sponsored by private companies. Beneficiaries, their appointed representatives, or physicians can ask sponsors to cover prescriptions restricted under their plan -- a process known as a coverage determination -- and can appeal denials to the sponsor and the independent review entity. This report reviews: (1) the processes for sponsors¿ coverage determination decisions and the approval rates; (2) the processes for appealing coverage denials and the approval rates at the sponsor and IRE levels; and (3) the Centers for Medicare and Medicaid Services¿ efforts to inform the public about sponsors¿ performance and oversee sponsors¿ processes. Charts.
Download or read book Medicare written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-09-15 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) established a voluntary outpatient prescription drug benefit, known as Medicare Part D. Private sponsors have contracted with the Centers for Medicare & Medicaid Services (CMS) to provide this benefit and are offering over 1,400 stand-alone prescription drug plans (PDP). Depending on where they live, beneficiaries typically have a choice of 40 to 50 PDPs, which vary in cost and coverage. MMA required each PDP sponsor to staff a toll-free call center, which serves as a key source of the information that beneficiaries need to make informed choices among PDPs. GAO examined (1) whether PDP sponsors provide prompt, courteous, and helpful service to Medicare beneficiaries and others and (2) the extent to which PDP sponsor call centers provide accurate and complete information to Medicare beneficiaries and other callers. To address these objectives, we made 900 calls to 10 of the largest PDP sponsor call centers during March 2006, posing one of five questions about their Part D plans during each call. We tracked the amount of time it took to reach a
Download or read book Report to the President written by and published by . This book was released on 2000 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt: On October 25,1999, the President directed the Secretary of Health and Human Services to study prescription drug costs and trends for Medicare beneficiaries. He asked that the study investigate: price differences for the most commonly used drugs for people with and without coverage; drug spending by people of various ages, as a percentage of income and of total health spending; and trends in drug expenditures by people of different ages, as a percentage of income and of total health spending. This report is the Department's response to that request. It represents the work of individuals and agencies throughout the Department, including the Agency for Healthcare Research and Quality (AHRQ), the Food and Drug Administration (FDA), the Health Care Financing Administration (HCFA), and the Office of the Assistant Secretary for Planning and Evaluation (ASPE).
Download or read book Medicare Primer written by Patricia A. Davis and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.
Download or read book Oversight Challenges in the Medicare Prescription Drug Program written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security and published by . This book was released on 2010 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medical and Dental Expenses written by and published by . This book was released on 1990 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Conditions of Participation for Hospitals written by United States. Social Security Administration and published by . This book was released on 1966 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Implementing the Medicare Prescription Drug Benefit and Medicare Advantage Program written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2005 with total page 310 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Departments of Labor Health and Human Services and Education and Related Agencies Appropriations for Fiscal Year 2017 written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 2017 with total page 866 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Fraud Waste and Abuse Challenges and Strategies for Preventing Improper Payments written by Kathleen M. King and published by DIANE Publishing. This book was released on 2010-10 with total page 15 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare¿s size and complexity make it vulnerable to fraud, waste, and abuse. Fraud represents intentional acts of deception with knowledge that the action or representation could result in an inappropriate gain, while abuse represents actions inconsistent with acceptable bus. or med. practices. Waste, which includes inaccurate payments for services, also occurs in the Medicare program. In 2009, the Centers for Medicare and Medicaid Services (CMS) estimated billions of dollars in improper payments in the Medicare program. This statement focuses on challenges facing CMS and selected key strategies that are particularly important to helping prevent fraud, waste, and abuse, and ultimately to reducing improper payments. Illustrations.
Download or read book Audit and Accounting Guide Property and Liability Insurance Entities 2018 written by AICPA and published by John Wiley & Sons. This book was released on 2018-12-12 with total page 569 pages. Available in PDF, EPUB and Kindle. Book excerpt: Get authoritative accounting and auditing guidance. Educate staff on the property and liability insurance industry, its products and regulatory issues, and the related transaction cycles an insurance entity is involved with. This guide contains updates on current GAAP and statutory accounting and audit guidance, as well as relevant guidance contained in standards issued through September 1, 2018 which have a major impact on insurance entities, including: FASB ASU No. 2016-01 and AICPA Q&A Section 7100.15: Insurance Companies and the Definition of Public Business Entity Revenue Recognition Implementation Issue: Considerations for Applying the Scope Exception in FASB ASC 606-10-15-2 and 606-10-15-4 to Contracts Within the Scope of FASB ASC 944
Download or read book Audit and Accounting Guide Property and Liability Insurance Entities 2016 written by AICPA and published by John Wiley & Sons. This book was released on 2018-02-21 with total page 640 pages. Available in PDF, EPUB and Kindle. Book excerpt: Considered the industry standard resource, this guide provides practical guidance, essential information and hands-on advice on the many aspects of accounting and authoritative auditing for employee benefit plans. This new 2016 edition is packed with information on new requirements -- including the simplification of disclosure requirements for investments in certain entities that calculate net asset value per share (or its equivalent), the simplification of disclosures for fully benefit-responsive investment contracts, plan investment disclosures, and measurement date practical expedient, and a new employee stock ownership plans chapter that includes both accounting and auditing.
Download or read book Medicare Prescription Drug Improvement and Modernization Act of 2003 written by CCH Incorporated and published by Wolters Kluwer. This book was released on 2004-01-01 with total page 642 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Care Fraud and Abuse written by Aspen Health Law Center and published by . This book was released on 1998 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.
