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Health: Survey of Medicare Clinics in Florida

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Report Type Reports and Testimonies
Report Date March 9, 1979
Report No. 120152
Subject
Summary:

A survey was conducted of regional Medicare clinics to determine whether adequate controls existed to monitor potential overutilization of the clinics by eligibles.

GAO found that the Health Care Financing Administration and the Florida carriers generally were aware of the problem and were taking action to control it by special utilization review procedures. However, a review of the Florida carriers' utilization controls indicated that beneficiary utilization screens for routine office visits were set at about four times the national average. Sample beneficiary histories were submitted to one carrier's claims review committee, whose members unanimously agreed that overutilization had occurred for services provided in the majority of cases.

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