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 11
... terminated and actively participating providers . As to carriers , we are focusing on the adequacy of processing controls to prevent duplicate payment of claims ; the propriety of reasonable charge payments to physicians and medical ...
... terminated and actively participating providers . As to carriers , we are focusing on the adequacy of processing controls to prevent duplicate payment of claims ; the propriety of reasonable charge payments to physicians and medical ...
Page 122
... termination of the economic stabilization program . We projected costs and use trends in a certain fashion and I must tell you our actuaries were badly mistaken and we lost a great deal of money as a result of those miscalculations . If ...
... termination of the economic stabilization program . We projected costs and use trends in a certain fashion and I must tell you our actuaries were badly mistaken and we lost a great deal of money as a result of those miscalculations . If ...
Page 126
... terminated . In other words , there is a kind of don't - rock - the boat approach that covers for the weak sister or ... termination . There have been a number of plans dropped because of merger considerations . We are now merging five ...
... terminated . In other words , there is a kind of don't - rock - the boat approach that covers for the weak sister or ... termination . There have been a number of plans dropped because of merger considerations . We are now merging five ...
Page 127
... termination as a device to solve performance prob- lems isn't as simple as it may appear to be . I think Mr. Tierney ... terminate a contractor in effect you are just taking the top 10 or 12 executives in a large plan and the board and ...
... termination as a device to solve performance prob- lems isn't as simple as it may appear to be . I think Mr. Tierney ... terminate a contractor in effect you are just taking the top 10 or 12 executives in a large plan and the board and ...
Page 146
... termination of existing Plan subcontracts as of June 30 , 1975 . I shall call you after January 1 , 1975 to arrange a meeting for the purpose of agreeing on a contract renegotiation schedule and reviewing the issues to be addressed in ...
... termination of existing Plan subcontracts as of June 30 , 1975 . I shall call you after January 1 , 1975 to arrange a meeting for the purpose of agreeing on a contract renegotiation schedule and reviewing the issues to be addressed in ...
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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...