United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1996-05-17 monographic deposited born digital 41 p. GA 1.13:HEHS-96-124 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-96-124 P0b002ee18038dd80 f:he96124 DGPO 2010-08-12 2011-03-23 GAOREPORTS-HEHS-96-124 machine generated eng fdlp REPORT GAOREPORTS-HEHS-96-124 HEHS-96-124 Health care services Medical economic analysis Hospitals Questionable payments Retired military personnel Military dependents Managed health care Public Health Service facilities Cost effectiveness analysis Health care cost control DOD TRICARE Program DOD Military Health Services System DOD Enrollment Eligibility Reporting System Civilian Health and Medical Program of the Uniformed Services CHAMPUS Medicare Program DOD Uniformed Services Treatment Facilities Program Letter Report HEHS

Pursuant to a congressional request, GAO reviewed the integration of uniformed services treatment facilities' (USTF) into the Department of Defense's (DOD) TRICARE Program, focusing on: (1) whether USTF members' use of Medicare and the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) results in unnecessary costs; and (2) other issues that need to be considered during USTF program reauthorization.<p/>GAO found that: (1) in fiscal year (FY) 1994, USTF members' use of Medicare resulted in over $9.5 million in unnecessary costs; (2) total unnecessary costs from members' Medicare use could total almost $38 million during FY 1994 to FY 1997; (3) DOD cannot fully recover unnecessary Medicare payments from USTF under current USTF agreements; (4) DOD and the Health Care Financing Administration (HCFA) lack the explicit authority to prevent Medicare-eligible USTF members from using Medicare; (5) DOD has been able to curb USTF members' use of military treatment facilities and CHAMPUS because it has controls in place to minimize such use; (6) Congress needs to consider how to serve USTF members' health care needs cost-effectively, given DOD implementation of TRICARE and its mandate to limit program costs; (7) some reports have indicated that the USTF managed care program costs DOD from $93 million to $193 million more per year than CHAMPUS; (8) Congress needs to consider whether USTF should retain their noncompetitive status after TRICARE implementation, and what the cost implications to TRICARE would be; and (9) USTF enrollment of Medicare-eligible members creates inequities for most older military retirees who rely on space-available care in military hospitals. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-96-124/html/GAOREPORTS-HEHS-96-124.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-96-124/pdf/GAOREPORTS-HEHS-96-124.pdf GAO/HEHS-96-124 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-96-124 Letter Report GAO/HEHS-96-124; Defense Health Care: Medicare Costs and Other Issues May Affect Uniformed Services Treatment Facilities' Future; Health care services Medical economic analysis Hospitals Questionable payments Retired military personnel Military dependents Managed health care Public Health Service facilities Cost effectiveness analysis Health care cost control DOD TRICARE Program DOD Military Health Services System DOD Enrollment Eligibility Reporting System Civilian Health and Medical Program of the Uniformed Services CHAMPUS Medicare Program DOD Uniformed Services Treatment Facilities Program Title 42 Section 248c 42 U.S.C. 248c Public Law 104-106