Medicare Administrative Costs: Hearings Before the Subcommittee on Oversight of the Committee on Ways and Means, House of Representatives, Ninety-fourth Congress, Second Session, August 2 and 27, 1976 |
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Page 4
... functions , while carriers are responsible for the payment of part B benefits Most of the intermediaries are local Blue Cross plans which are subcontractors of the Blue Cross Association , and most of the carriers are Blue Shield plans ...
... functions , while carriers are responsible for the payment of part B benefits Most of the intermediaries are local Blue Cross plans which are subcontractors of the Blue Cross Association , and most of the carriers are Blue Shield plans ...
Page 9
... functions were substantially higher . Mr. STARK . I would like to ask if this is the study which is now being redone which originally showed BHI at a higher cost per claim than two of the Blues ? When redone , this actually will show ...
... functions were substantially higher . Mr. STARK . I would like to ask if this is the study which is now being redone which originally showed BHI at a higher cost per claim than two of the Blues ? When redone , this actually will show ...
Page 25
... functions as determining eligibility for medicare benefits , issuing health insurance cards , collecting premiums and maintaining national records on bene- ficiary utilization of covered services . These are functions performed by the ...
... functions as determining eligibility for medicare benefits , issuing health insurance cards , collecting premiums and maintaining national records on bene- ficiary utilization of covered services . These are functions performed by the ...
Page 28
... functions to be per- formed and , in total , the contractors identify the various elements of costs that make up their budget requests , such as , salaries , fringe benefits , travel , space and equipment . The BHI regional offices ...
... functions to be per- formed and , in total , the contractors identify the various elements of costs that make up their budget requests , such as , salaries , fringe benefits , travel , space and equipment . The BHI regional offices ...
Page 30
... functions performed by the contractors , the cost of each of those functions and their relationship to the total administrative costs for the July - March period : TABLE 1. - MEDICARE CONTRACTOR FUNCTIONS [ Dollar amounts in thousands ] ...
... functions performed by the contractors , the cost of each of those functions and their relationship to the total administrative costs for the July - March period : TABLE 1. - MEDICARE CONTRACTOR FUNCTIONS [ Dollar amounts in thousands ] ...
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Common terms and phrases
accounting activities administrative costs agreement allocation amount Article Audit Agency BCA's benefits bill Blue Cross Association Blue Cross plans Blue Cross-Blue Shield Blue Shield budget Bureau of Health carriers changes charge claims processing committee CONGRESS THE LIBRARY contract contractors cost accounting standards cost reports data processing determined developed effective executive executive compensation expenses Federal Health Insurance Federal Procurement Regulations fiscal funds Government HEW Audit hospital increase incurred instructions Intermediary issues letter of credit LIBRARY OF CONGRESS Medicaid Medicare program million negotiation operations organizations panel paragraph payment percent performance physicians prior approval private sector problems procedures Professor LAW proposed providers of services question RANGEL rate review record reimbursement responsibility role salaries Secretary Social Security Administration specific staff STARK STEPNICK subcontract submit Suycott tape-to-tape TIERNEY tion TRESNOWSKI utilization review vice president Wisconsin
Popular passages
Page 220 - Contractor shall proceed diligently with the performance of the contract and in accordance with the Contracting Officer's decision. (b) This "Disputes" clause does not preclude consideration of law questions in connection with decisions provided for in paragraph (a) above : Provided, That nothing in this contract shall be construed as making final the decision of any administrative official, representative, or board on a question of law.
Page 196 - Defense to procure supplies and services from responsible sources at fair and reasonable prices calculated to result in the lowest ultimate overall cost to the Government.
Page 194 - The decision of the Secretary or his duly authorized representative for the determination of such appeals shall be final and conclusive unless determined by a court of competent Jurisdiction to have been fraudulent, or capricious, or arbitrary, or so grossly erroneous as necessarily to imply bad faith, or not supported by substantial evidence.
Page 199 - Disputes" clause of this contract, (2) litigation or the settlement of claims arising out of the performance of this contract, or (3) costs and expenses of this contract as to which exception has been taken by the Comptroller General or any of his duly authorized representatives, shall continue until such appeals, litigation, claims, or exceptions have been disposed of.
Page 168 - No disbursing officer shall, in the absence of gross negligence or intent to defraud the United States, be liable with respect to any payment by him under this...
Page 180 - Except as otherwise provided in this contract, any dispute concerning a question of fact arising under this contract which is not disposed of by agreement shall be decided by the Contracting Officer, who shall reduce his decision to writing and mail or otherwise furnish a copy thereof to the Contractor.
Page 202 - Contractor, was then of said Corporation; that said Contract was duly signed for and in behalf of said Corporation by authority of its governing body, and is within the scope of its corporate powers.
Page 168 - No certifying or disbursing officer shall be held liable for any amount certified or paid by him in good faith to any person where the recovery of such amount is waived under subsection (c) of this section or has been begun but cannot be completed under subsection (a) of this section.
Page 183 - I know his signature, and his signature thereto is genuine; and that said bond was duly signed, sealed, and attested for and in behalf of said corporation by authority of its governing body. ["Corporate"!
Page 134 - ... by providers of services and other persons to individuals entitled to benefits under this part, and provide procedures for and assist in arranging, where necessary, the establishment of groups outside hospitals (meeting the requirements of section...