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HRD-82-58 1 (1982-04-19)

handle is hein.gao/gaobabdfj0001 and id is 1 raw text is: 


                     UNITED STATES GENERAL ACCOUNTING OFFICE f I
                             WASHINGTON, D.C. 20548

HUMAN NZUCR
   DIO          RKSTRICTED -Pot to fie rAe (nsido to ,oneu'm
                 Accounting  office excpt  c :  s  of specific a' r8APRSL 19, 1982
     B-207017    by the Office of Con 'u  t%&,s

                                                 RELEASED
     The Honorable Matthew J. Rinaldo
     House of Representatives

     Dear Mr. Rinaldo:

          Subject: Inquiry About Alleged Discriminatory Medicare
                     Part B Reimbursement in New Jersey (HEM-82-58)

          This is in response to your request for a study of allegations
     of discriminatory rate reimbursement to New Jersey senior citizens
     under the Supplemental Medical Insurance program (MIedicare part 3).
     The allegations were contained in a July 1981 report entitled
     What's Wrong With Medicare Part B in New Jersey? by the Medicare
     Task Force of the New Jersey Federation of Senior Citizens.

          We found that, although beneficiaries in New Jersey are paying
     a substantial portion of their medical costs for services which are
     covered by part B, they are on the average no worse off than bene-
     ficiaries elsewhere in the Nation. The level of reimbursement for
     benefits within the State is affected by reimbursement localities;
     that is, the different areas within the State for which maximum
     payment levels are set. While current charge data suggest that
     chances might be warranted in the locality designations, such
     changes would likely result in some beneficiaries being helped
     and others hurt financially.

     SCOPE AND METHODOLOGY

           We visited the Millville, New Jersey, office of The Prudential
      Insurance Company of America, the carrier which, under contract
      with the Department of Health and Human Services' Health Care
      Financing Administration (HCFA), is responsible for administering
      Medicare part B in New Jersey. We discussed the equity of reim-
      bursement in various parts of the State with Prudential officials.
      We also analyzed copies of available studies and data related to
      this issue. According to Prudential officials, the most detailed
      study available was completed in January 1982. An explanation of
      the data and our analysis is provided in enclosure Ill.


             Slflll~ II fll                                      (106222)


             118328

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