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HRD-83-74 1 (1983-09-30)

handle is hein.gao/gaobabefy0001 and id is 1 raw text is: /;40Lb J


BY THE U.S. GE'NERAL ACCOUNTING OFFICE


Report To The Secretary Of Health

And Human Services









Need To Eliminate Payments For

Unnecessary Hospital Ancillary Services




About 6 percent of the charges for ancillary
services provided to a sample of Medicare
beneficiaries at 16 hospitals represented
unnecessary care. All of the unnecessary
are was paid by Medicare because of the
  bsence of effective medical necessity re-
  Views.

  4edicare's new prospective reimbursement
  ystem will provide an incentive for hospi-
  tals to eliminate unnecessary ancillary serv-
  ices. A remaining problem, however, is that
  l he reimbursement rates under the new sys-
  em are based in part on costs of providing
  unnecessary care. GAO recommends that
  HHS eliminate the cost of such care from
  the data base used to establish the rates.

  !GAO also noted that the Medicaid program
  was vulnerable to the payment for unneces-
  :sary ancillary services.







  0)                                                           122480


                                                              GAO/HRD-83-74
                                                              SEPTEMBER 30.,1993

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