October 18, 2021

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Special Envoy Malley’s Trip to the Middle East 

6 min read

Office of the Spokesperson

Special Envoy for Iran Robert Malley will travel to the United Arab Emirates, Qatar and Saudi Arabia from October 15-21 to meet and discuss with our Gulf partners a range of concerns with Iran, including its activities in the region and our attempt to negotiate a mutual return to compliance with the Joint Comprehensive Plan of Action.]

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Specifically, payment rates in Alaska were considerably higher than the national payment rates, whereas payment rates in Hawaii and the territories were largely somewhat higher than the national payment rates for services examined. For example, payment rates for selected services in Alaska ranged from about 26 percent higher for an eye exam and treatment to about 39 percent higher for an emergency department visit. For Puerto Rico and the U.S. Virgin Islands, payment rates were less than 1 percent greater than the national payment amount. GAO analysis of 2019 Medicare Part B FFS claims data shows that utilization and expenditures for the 12 selected services in its review were generally lower in Alaska, Hawaii, and the territories when compared to national rates. For example, Alaska, Hawaii, and all U.S. territories had lower per beneficiary utilization of outpatient evaluation and management services under the Physician Fee Schedule than national per beneficiary utilization in 2019. Per beneficiary use for these services ranged from 1.1 services in American Samoa to 5.6 services in Hawaii, less than the national rate of 6.1 services. Partly due to lower per beneficiary utilization, per beneficiary expenditures for all selected services were also lower in Alaska, Hawaii, and the territories compared to national Part B FFS per beneficiary expenditures in 2019. Specifically, they ranged from about $183 in American Samoa to about $627 in Alaska, compared with national per beneficiary expenditures of about $735. Why GAO Did This Study Certain state and territory stakeholders have raised questions about payment rates under the Medicare Physician Fee Schedule for Alaska, Hawaii, and the territories. They noted that the rates might not take into account unique characteristics which may affect the delivery of care. 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GAO analyzed Medicare data from 2019—the most recent year of data available at the time of its review—to describe Medicare beneficiaries in Alaska, Hawaii, and the territories. GAO used the Medicare Physician Fee Schedule Search Tool to determine payment rates for the 12 selected services based on Medicare spending in 2019 and compared them to the national payment amount. GAO also analyzed Medicare claims data from 2019 to determine per beneficiary utilization and expenditures for Alaska, Hawaii, and the territories. GAO compared them to national Medicare per beneficiary utilization and expenditures. To supplement this work, GAO obtained information from health officials in the states and territories and examined key documents. For more information, contact Jessica Farb at (202) 512-7114 or FarbJ@gao.gov.
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