Managed Care And The Law

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Law and Practice of Private Health Insurance and Managed Care

Author : Christian Funk
Publisher : diplom.de
Page : 143 pages
File Size : 55,6 Mb
Release : 2000-04-28
Category : Medical
ISBN : 9783832423216

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Law and Practice of Private Health Insurance and Managed Care by Christian Funk Pdf

Inhaltsangabe:Abstract: A true revolution has taken place in the financing of health care in America. Today, managed care is dominating the way Americans receive and pay for their health care. With the rise of managed care medicine has been wrenched out of its atomized world of solo physician practices and community hospitals and has been transformed into a modern industry of giant for-profit companies traded on Wall Street. The current marketplace is characterized by mergers, acquisitions and the establishment of giant multi-billion dollar healthcare networks. Hospitals and managed care plans run big advertisement campaigns in the media, praising their products and services in order to get the biggest share possible of the $1.1 trillion America spends on health care each year. All parties involved in providing health care lobby for their interests at all levels of political decision-making in order to influence legislators and policymakers. Today s health care market changes quickly and at a high rate. New variations of managed care arise constantly making any analysis of managed care an ongoing game of "catch-up" with the marketplace. While writing this paper, for example, UnitedHealthcare dropped one of the major managed care instruments, utilization review, to address public s concerns and pending legislation. This paper will take a snapshot of managed care on the eve of the new millennium by using the most recent information available. After this introduction, the paper will give a description of the current American health care system in chapter two (The U.S. Health Care System). Then, the paper will focus on two aspects: A detailed description of managed care in chapter three (Managed Care) and an introduction of the main issues connected with this way of providing health care in chapter four (Managed Care issues). The paper will argue in chapter five (Results and Future Developments), that managed care of the future will be a light version of what is currently existing, resulting in less strict restrictions and more freedom for patients and doctors. Finally, the report will focus on recent developments in Germany, where policy-makers have started to adopt particular elements of managed care. In chapter six (Managed Care Approaches in Germany), the paper will argue, that Germany should pay more attention to the American experiences regarding managed care in order to prevent harm for patients in [...]

Guide to State Medicaid Managed Care Laws and Rules

Author : Jane M. Anderson
Publisher : Jones & Bartlett Learning
Page : 98 pages
File Size : 42,5 Mb
Release : 1999
Category : Law
ISBN : 083421606X

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Guide to State Medicaid Managed Care Laws and Rules by Jane M. Anderson Pdf

Guide to State Medicaid Managed Care Laws and Rules: 1999 Edition reveals the current legislative and regulatory climate regarding Medicaid in every state, including federal waivers applied for and granted. It's the most complete and current information available on how you can maintain or increase your number of covered lives. In one easy-to-use guide you get specific details of each state's Medicaid laws and rules, including: * choice of physician, * provider reimbursement, * benefits packages, * quality assurance, * utilization management, and * names of contacts at state agencies, Best of all, you'll get the details on contracting with each state, as specified by the state Medicaid office itself. You'll also get hard-to-find answers to critical questions such as: * Which states allow Medicaid patients to choose their own physicians? * How do Medicaid provider reimbursement to choose their own physicians? * What are the rules on provider network development in states where you want to do business? Get the answer to these questions and many more in Guide to State Medicaid Managed Care Laws and Rules: 1999 Edition.

Managed Care and the Law

Author : Charles G. Benda,Fay A. Rozovsky
Publisher : Aspen Publishers
Page : 506 pages
File Size : 53,6 Mb
Release : 2024-06-03
Category : Electronic
ISBN : 0316174084

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Managed Care and the Law by Charles G. Benda,Fay A. Rozovsky Pdf

Strangers in the Night

Author : Peter D. Jacobson
Publisher : Oxford University Press
Page : 320 pages
File Size : 44,6 Mb
Release : 2002-08-08
Category : Law
ISBN : 9780190288297

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Strangers in the Night by Peter D. Jacobson Pdf

More than ever before, the legal system plays a vital role in virtually every aspect of the current health care system. From the congressional debate over patients' rights legislation to judicial rulings on the denial of health care services, the legal system is integrally involved in the organization, financing, and delivery of health care. This book explains how the legal system helps shape health care delivery and policy, explores new ways of looking at the relationship between law and medicine, and reflects on why it all matters. The story focuses on the judicial response to the advent of managed care, especially challenges to cost containment initiatives, and shows how the legal system has facilitated managed care's dominance over the health care system. An equally important part of the story is the evolution of the relationship between physicians and attorneys and how their mutual antagonism affects patient care. In the end, the stories come together around a strategy for reconciling the difficult health policy choices the country faces and for restoring the physician-patient relationship to the center of health care delivery.

State by State Guide to Managed Care Law

Author : Donald R. Levy,Molly Stauffer,Rachel Bevins Morgan
Publisher : Aspen Publishers
Page : 560 pages
File Size : 45,6 Mb
Release : 2000-12
Category : Business & Economics
ISBN : 0735518440

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State by State Guide to Managed Care Law by Donald R. Levy,Molly Stauffer,Rachel Bevins Morgan Pdf

Until now, the search for information on managed care was 5 times as difficult as it had to be. Now, you can examine & compare regulatory policies state by state. The State by State Guide to Managed Care Law simplifies & expediates your research by giving you immediate access to key court decisions, state managed care policies & practices, & extensive citations to codes & regulations for all 50 states. Identify your issue in the index & turn to the page indicated. You'll find current, authoritative information that can help you: Evaluate baseline quality standards, determine when managed care enrollees have access to providers Establish guidelines for collection & disclosure of financial information Arm yourself to tackle the complicated issue of prescription drugs Ensure the managed care organization recognizes patients' & providers' due process rights. Whether you are involved in the design, delivery, or regulation of managed care, you can count on State by State Guide to Managed Care Law for a valuable national snapshot. Managed care is undeniably a permanent part of the health care landscape, so keep this portable & precise reference close at hand for daily consultation.

Guide to Key Legal Issues in Managed Care Quality

Author : Alice G. Gosfield
Publisher : Faulkner & Gray, Incorporated
Page : 253 pages
File Size : 54,8 Mb
Release : 1996-01-01
Category : Managed care plans (Medical care)
ISBN : 1881393712

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Guide to Key Legal Issues in Managed Care Quality by Alice G. Gosfield Pdf

Managed Care and the Law

Author : Charles G. Benda,Fay Adrienne Rozovsky
Publisher : Aspen Publishers
Page : 400 pages
File Size : 53,6 Mb
Release : 1995
Category : Law
ISBN : 0316088927

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Managed Care and the Law by Charles G. Benda,Fay Adrienne Rozovsky Pdf

Managed Care Law Manual

Author : Aspen Health Law Center
Publisher : Aspen Publishers
Page : 128 pages
File Size : 53,5 Mb
Release : 1998-01-01
Category : Law
ISBN : 0834208482

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Managed Care Law Manual by Aspen Health Law Center Pdf

Managed Care Legal Issues

Author : Bruce A. Johnson,Gerald A. Niederman
Publisher : Unknown
Page : 260 pages
File Size : 42,7 Mb
Release : 1996
Category : Managed care plans (Medical care)
ISBN : 1568290764

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Managed Care Legal Issues by Bruce A. Johnson,Gerald A. Niederman Pdf

Managed Care

Author : Anonim
Publisher : Jones & Bartlett Learning
Page : 184 pages
File Size : 46,8 Mb
Release : 1998
Category : Managed care plans (Medical care)
ISBN : 0834211203

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Managed Care by Anonim Pdf

As a result of intense lobbying by consumers and health care providers, managed care organizations are under close scrutiny. More and more frequently, states are taking assertive roles in governing managed care operations, including monitoring how they contract with providers and what types of benefits they provide to enrollees. In this volume, you'll learn how MCOs nationwide are being held accountable to a complex array of new laws -- and what you can expect and demand from MCOs according to new laws.

State by State Guide to Managed Care Law 2008 Edition

Author : John F. Buckley
Publisher : Aspen Publishers
Page : 500 pages
File Size : 46,6 Mb
Release : 2007-12-04
Category : Business & Economics
ISBN : 0735566011

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State by State Guide to Managed Care Law 2008 Edition by John F. Buckley Pdf

State by State Guide to Managed Care Law simplifies and expedites your research by giving you immediate access to key court decisions, state managed care policies and practices, and extensive citations to codes and regulations - for all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you to: ; Evaluate baseline quality standards Determine when managed care enrollees have access to providers Establish guidelines for collection and disclosure of financial information Arm yourself to tackle the complicated issue of prescription drugs Ensure that the managed care organization recognizes patients' and providers' due process rights

State by State Guide to Managed Care Law, 2014 Edition

Author : John F. Buckley,Nicole D. Prysby
Publisher : Wolters Kluwer Law & Business
Page : 548 pages
File Size : 54,6 Mb
Release : 2013-11-12
Category : Law
ISBN : 1454825804

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State by State Guide to Managed Care Law, 2014 Edition by John F. Buckley,Nicole D. Prysby Pdf

State by State Guide to Managed Care Law simplifies and expedites your research by giving you immediate access to key court decisions, state managed care policies and practices, and extensive citations to codes and regulations - for all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you to: Evaluate baseline quality standards Determine when managed care enrollees have access to providers Establish guidelines for collection and disclosure of financial information Arm yourself to tackle the complicated issue of prescription drugs Ensure that the managed care organization recognizes patients' and providers' due process rights The 2014 Edition has been updated to include: Changes to administrative requirements for HMOs for five states, including preexisting condition provisions and anti-discrimination provisions Updates to provider access laws for six states Revisions to coverage of Rhode Island and Virginia clinical trial protocol requirements for coverage by HMOs Revised requirements for coverage of drugs and prostheses for nine states, including new oral cancer drug requirements for six states Updates to prompt payment requirements in five states Changes to consumer assistance laws for three states

Managed Care Law 2003

Author : Donald R. Levy,Rachel Bevins Morgan
Publisher : Aspen Publishers
Page : 656 pages
File Size : 48,6 Mb
Release : 2002-12-10
Category : Business & Economics
ISBN : 0735532214

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Managed Care Law 2003 by Donald R. Levy,Rachel Bevins Morgan Pdf

Until now, the search for information on managed care was 5 times as difficult as it had to be. Now, you can examine and compare regulatory policies state by state. the State by State Guide to Managed Care Law simplifies and expedites your research by giving you immediate access to key court decisions, state managed care policies and practices, and extensive citations to codes and regulations - for all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you:Evaluate baseline quality standards; determine when managed care enrollees have access to providersEstablish guidelines for collection and disclosure of financial informationArm yourself to tackle the complicated issue of prescription drugsEnsure the managed care organization recognizes patients' and providers' due process rights.Managed care is undeniably a permanent part of the health care landscape, so keep this portable and precise reference close at hand for daily consultation.

Managed Care Law Manual

Author : Patricia A. Younger,Cynthia Conner
Publisher : Aspen Publishers
Page : 128 pages
File Size : 40,8 Mb
Release : 1994-04
Category : Law
ISBN : 0834205238

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Managed Care Law Manual by Patricia A. Younger,Cynthia Conner Pdf

This manual is a unique legal guide specific to managed care filled with the facts health care attorneys, managed care organizations, & health care administrators need to make informed choices. This legal guide will help you know not only your legal obligations, but also those of your contracting partners employers, third-party payers, physicians, & others so you can form the joint alliances that will be essential in the health care reform days ahead. This manual is always current with twice a year updates.

Managed Care Law Manual

Author : Anonim
Publisher : Unknown
Page : 128 pages
File Size : 47,7 Mb
Release : 1994
Category : Managed care plans (Medical care)
ISBN : 0834205238

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Managed Care Law Manual by Anonim Pdf