Managed Care Law 1999

Author : Molly Stauffer,Donald R. Levy
Publisher : Aspen Publishers
Page : 238 pages
File Size : 53,5 Mb
Release : 1998-10-16
Category : Managed care plans (Medical care)
ISBN : 0735502137

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Managed Care Law 1999 by Molly Stauffer,Donald R. Levy Pdf

Unitl 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 expediates 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 providers, establish guidelines for collection and disclosure of financial information, arm yourself to tackle the complicated issue of prescription drugs, and ensure the managed care organization recognizes patients' and 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 for a valuable national snapshot. 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.

Author : Jane M. Anderson
Publisher : Jones & Bartlett Learning
Page : 120 pages
File Size : 40,6 Mb
Release : 1999
Category : Managed care plans (Medical care)
ISBN : 0834216051

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State-by-State Laws and Regulations on Workers' Compensation Managed Care by Jane M. Anderson Pdf

As the implementation of workers' compensation managed care programs spreads, the volume of state rules and regulations for the industry multiplies as well. And as you know, keeping track of the various iterations is an extremely difficult task. The future holds more regulation, not less. You need a resource that allows you to quickly scan summaries of the latest laws and regulations in each state to easily identify opportunities around the country to expand you business. State-by-State Laws and Regulations on Workers' Compensation Managed Care covers all the rules on every aspect of workers' compensation, including choice of physicians ... utilization review ... provider reimbursement ... cost containment dispute resolution ... 24-hour care ... and much more. Completely updated to include numerous new laws passed since the last edition was published, the 1999 Edition helps you: identify states with favorable -- or unfavorable conditions for expanding your business -- watch out for changes in what you can, can't and must do in states where you already do business -- know in advance which products and programs can -- and can't -- succeed in states where you plan to do business. Don't miss out of profit opportunities -- or run afoul of the law -- just because you don't know the rules.

Author : Jane M. Anderson
Publisher : Aspen Publishers
Page : 100 pages
File Size : 52,8 Mb
Release : 1999
Category : Law
ISBN : UOM:49015002864479

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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.

Author : National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Health Care Utilization and Adults with Disabilities
Publisher : National Academies Press
Page : 161 pages
File Size : 42,8 Mb
Release : 2018-04-02
Category : Medical
ISBN : 9780309469210

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Health-Care Utilization as a Proxy in Disability Determination by National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee on Health Care Utilization and Adults with Disabilities Pdf

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Author : Institute of Medicine,Committee on the Changing Market, Managed Care, and the Future Viability of Safety Net Providers
Publisher : National Academies Press
Page : 304 pages
File Size : 52,8 Mb
Release : 2000-09-04
Category : Medical
ISBN : 9780309064972

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America's Health Care Safety Net by Institute of Medicine,Committee on the Changing Market, Managed Care, and the Future Viability of Safety Net Providers Pdf

America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.

Author : Christian Funk
Publisher : diplom.de
Page : 143 pages
File Size : 40,6 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 [...]

Author : Anonim
Publisher : Unknown
Page : 1796 pages
File Size : 44,9 Mb
Release : 2000
Category : Medicine
ISBN : OSU:32436010864583

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Cumulated Index Medicus by Anonim Pdf

Author : Institute of Medicine,Board on Health Sciences Policy,Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care
Publisher : National Academies Press
Page : 781 pages
File Size : 45,7 Mb
Release : 2009-02-06
Category : Medical
ISBN : 9780309082655

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Unequal Treatment by Institute of Medicine,Board on Health Sciences Policy,Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care Pdf

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Author : Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance
Publisher : National Academies Press
Page : 213 pages
File Size : 45,9 Mb
Release : 2002-06-20
Category : Medical
ISBN : 9780309083430

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Care Without Coverage by Institute of Medicine,Board on Health Care Services,Committee on the Consequences of Uninsurance Pdf

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

Author : Michael A. Fauman
Publisher : American Psychiatric Pub
Page : 129 pages
File Size : 53,8 Mb
Release : 2008-08-13
Category : Medical
ISBN : 9781585627660

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Negotiating Managed Care by Michael A. Fauman Pdf

For many psychiatrists and other mental health professionals, the clinical review is the most burdensome and disagreeable part of managed care. In that review they are asked, by a representative of the managed care company, to justify their patient's need for care and to defend the treatment they are providing. Clinicians usually feel at a disadvantage in these discussions because they are never quite sure what information the reviewer needs to approve the patient's care. This does not have to be the case. The goal of this book is to teach psychiatrists, mental health professionals, and administrators how reviewers think and how to conceptualize, present, and document clinical care in a manner that greatly increases the likelihood that reviewers will approve their request for care. Beginning with five questions that must be answered in every managed care review, the author discusses the following key topics and many others. Presenting your case to a reviewer -- How to effectively present requests for inpatient, partial hospital, and substance abuse care and avoid common mistakes that decrease the likelihood that your request will be approved. How to answer the four clinical questions that must be addressed in every review even if they are not asked by the reviewer. Negotiating with the reviewer -- How to negotiate with a reviewer who is reluctant to approve the care you request. Writing effective notes -- How to write effective clinical notes in the patient's record that substantiate your request for care and increase the likelihood that it will be approved. Dealing with unethical reviewers -- How to identify and take action against unethical reviewers and managed care companies that are insensitive to your patient's clinical needs. Appealing denials of care -- How to appeal denials of care when you do not agree with the reviewer's decision. These and many other important issues are highlighted in brief vignettes illustrating a clinician's presentation of a patient's case and a typical reviewer's comments. This tremendously useful volume will be welcomed by every mental health care practitioner who must negotiate the current managed care landscape.

Author : Robert B. Hackey,David A. Rochefort
Publisher : Unknown
Page : 336 pages
File Size : 46,5 Mb
Release : 2001
Category : Medical
ISBN : UOM:39015050789992

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The New Politics of State Health Policy by Robert B. Hackey,David A. Rochefort Pdf

State governments in the past decade have had to take on the problem of health care, with mixed results. This collection of 11 essays (of which two are an introduction and conclusion) by academics and policy makers consider the many issues that concern health care in the US and their effects at the state level, including managed care, health insurance expansion, mental health care, public health administration, and bureaucratic reactions to health policy. Hackey teaches health policy and management at Providence College in Rhode Island; Rochefort teaches political science and public administration at Northeastern U. in Boston. c. Book News Inc.

Author : Timothy Caulfield,Barbara von Tigerstrom
Publisher : University of Alberta
Page : 292 pages
File Size : 55,9 Mb
Release : 2002
Category : Health & Fitness
ISBN : 0888643667

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Health Care Reform and the Law in Canada by Timothy Caulfield,Barbara von Tigerstrom Pdf

Sweeping changes are being proposed as Canadians examine our health care system. But what are the legal implications of health care reform? In this timely collection, lawyers and legal scholars discuss a variety of topics in health care reform, including regulation of private care, interpretation of the Canada Health Act, and the constitutional implications of proposed reforms. Barbara von Tigerstrom is currently studying at the University of Cambridge in England. Timothy Caulfield lives in Edmonton, where he teaches at the University of Alberta.

Author : Theodore R Marmor
Publisher : World Scientific
Page : 172 pages
File Size : 51,7 Mb
Release : 2007-03-28
Category : Managed care plans (Medical care)
ISBN : 9789814472982

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Fads, Fallacies and Foolishness in Medical Care Management and Policy by Theodore R Marmor Pdf

No one misses the onslaught of claims about reforming modern medical care. How doctors should be paid, how hospitals should be paid or governed, how much patients should pay when sick in co-payments, how the quality of care could be improved, and how governments and other buyers could better control the costs of care ? all find expression in the explosion of medical care conference proceedings, op-eds, news bulletins, journal articles, and books. This collection of articles takes up a key set of what the author regards as particularly misleading fads and fashions ? developments that produce a startling degree of foolishness in contemporary discussions of how to organize, deliver, finance, pay for and regulate medical care services in modern industrial democracies. The policy fads addressed include the celebration of explicit rationing as a major cost control instrument, the belief in a ?basic package? of health insurance benefits to constrain costs, the faith that contemporary cross-national research can deliver a large number of transferable models, and the notion that broadening the definition of what is meant by health will constitute some sort of useful advance in practice.Contents: Fads in Medical Care Policy and Politics: The Rhetoric and Reality of ManagerialismHow Not to Think About ?Managed Care?Medical Care and Public Policy: The Benefits and Burdens of Asking Fundamental QuestionsMedicare and Political Analysis: Omissions, Understandings, and MisunderstandingsComparative Perspectives and Policy Learning in the World of Health CareHow Not to Think About Medicare Reform Readership: Graduate students in public policy, comparative politics, management, nursing, medicine, and social sciences; medical writers; medical professionals.

Author : Anonim
Publisher : Unknown
Page : 113 pages
File Size : 49,6 Mb
Release : 2000
Category : Emerging infectious diseases
ISBN : LCCN:99069869

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Managed Care Systems and Emerging Infections by Anonim Pdf

Author : Anonim
Publisher : Unknown
Page : 1 pages
File Size : 45,7 Mb
Release : 2013
Category : Electronic
ISBN : OCLC:1034664495

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Veterans Independence Program by Anonim Pdf

"The Veterans Independence Program (VIP) helps you remain independent and self-sufficient at home or in your community. Depending on your circumstances and health needs, Veterans Affairs Canada (VAC) can offer financial assistance to obtain a wide range of services, including: housekeeping; grounds maintenance, such as snow removal or lawn mowing; personal care; care and support from a health professional; home adaptations; access to nutrition; and ambulatory health care"--Page [1].