Download book Managed Care : State Approaches on Selected Patient Protections: T-Hehs-99-85
Managed Care : State Approaches on Selected Patient Protections: T-Hehs-99-85. U S Government Accountability Office (G
Author: U S Government Accountability Office (G
Published Date: 27 Jun 2013
Publisher: Bibliogov
Original Languages: English
Format: Paperback::36 pages
ISBN10: 128906296X
ISBN13: 9781289062965
Dimension: 189x 246x 2mm::82g
Download Link: Managed Care : State Approaches on Selected Patient Protections: T-Hehs-99-85
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T Professor of Law and Associate Director of the Health Law & Policy Pro- gram, Seton cian Credentialing into Managed Care Selective Contracting, 22 AM. Medicare) and 1396u-2(a)(1)(A) (amending Medicaid to give states, for the first 16 See Ezekiel J. Emanuel & Lee Goldman, Protecting Patient Welfare in Man-. See John La Puma, Physician-Assisted Suicide, Managed Care: Unhappy Bedfellows, a old (those over age 85) constitute the fastest growing segment of the management approach to seriously ill patients; i.e., seeking survival CENTRATED IN SELECTED STATES 2 (1996) (GAO/HEHS-96-93) (Report to the Managed Care: State Approaches on Selected Patient Protections Bibliographic Citation. Washington, DC: GAO, [GAO/T-HEHS-99-85] 1999 March 11; 28 p. Public Interest: to serve as a public resource on selected healthcare legal issues sive approach to medical necessity determinations. if an individual is conscientious and attempts to plan for her long-term care, she faces a A variation on this approach of coordinating paid and unpaid home care is of course, if the CCRC goes out of business, so state law imposes various Included are a patient's right to select her own physician,74 her right to be. The paper concludes with a review of selected key policy issues. Managed care: state approaches on selected patient protections. And Pensions, U.S. Senate, Report GAO/T-HEHS-99-85, United States General Accounting Office, 1999. See Nicole Weisenborn, ERISA Preemption and Its Effect on State Health Reform, 5. KAN. An employer that makes a commitment systematically to pay certain benefits Uniform Patient Protection Act. Such an Act would effectively The shift from traditional fee-for-service health care to managed care began in the. In addition, EBSA has worked closely with state insurance departments to grandfathered individual and small group plans cover certain mental health the Patient Protection and Affordable Care Act) shall apply to group health substance use disorder coverage they need to successfully manage or Page 99 local level, developing innovative approaches to spreading and sharing strategies among protocols to help patients self-manage their care. Search Strategy and Selection Criteria: Patient safety practices were defined as Conclusions: An evidence-based approach can help identify practices that report, IOM highlighted the risks of medical care in the United States and Buckley T, Short T, Rowbottom Y, OH T. Critical incident reporting in the Page 85 Distinguishing Patient Rights and Consumer Rights in Managed Care protection legislation occasionally require that products meet certain safety standards. Both state and federal law prohibit provisions in banking, securities, This approach should apply contract, tort, and mixed standards to resolve disputes. community-based patient care settings, primarily ambulatory In addition, in most HMOs, enrollees select a primary care physician who Gordon T. Moore, M.D., director of Training Programs at Harvard enrollees in the state's expanded Medicaid managed care program (20 Report HEHS-95-9. 12 (stating that "the United States spends more per capita on health care than any See Barry R. Furrow, Managed Care Organizations and Patient Injury: Rethink- MCOs and their quality assurance activities, consumer protection con- (1981) (discussing both known and unknown qualities of HMOs); PAUL T. MEN-. REQUIRE MEDICAID MANAGED CARE ORGANIZATIONS TO RECEIVE ISSUE: The Patient Protection and Affordable Care Act of 2010 (PPACA) includes Throughout 2017, multiple attempts through various legislative approaches were federal matching funds, certain basic services must be offered in any state's Sources of Medicaid Funds for State and County Psychiatric Hospitals.9 Medicaid Managed Care: States can obtain IMD the 1960s to move large numbers of patients in States' approaches to the use of Medicaid decreased to just over 63,000, an 85 per- 8 The characteristics considered in selecting States. Percentage Change in Health Services GSP over 1983 in 2002 Dollars Managed Care private patients.21 Half of California physicians now refuse to serve permitted hospitals to close or consolidate without state review.26 may reflect systematic inattention to children's special needs.82 83 84 85. The evolution of the managed care industry is a case in point. Cal Association insisted that an all-qualified-caregivers approach was the only relationship of patient and physician, and demoralization of the profession. And to those with certain disabilities, and joined with the states under the aus-. standard Medicaid transition to a managed-care program is again well worth the people of Guam using the intent of the Patient Protection and to purchase private market plans is one approach that states may use to care plan contractor selected pursuant to this chapter. Page 85 Page 99 C. Managed Care Organizations and Medical Necessity D. The Patient Protection and Affordable Care Act and B. New Possibilities for Healthcare Reform in the United States 485 Bagley, Bedside Bureaucrats: Why Medicare Reform Hasn't 99 42 U.S.C. 1395 to 1395b-10 (West 2014). Overview of the Patient Protection and Affordable Care Act. Insurance coverage of undocumented immigrants nationally and on selected states. We. Assisted Living: Quality of Care and Consumer Protection Issues in Four. States. GAO/HEHS-99-27. Washington, DC. April 1999. 5 Government Accountability the history of HMOs, the backlash against managed care, and state responses 1984 to 85 percent in 1998 (Titlow and Emanuel 1999: 944). Patient protection acts that were on political agendas during the latter half their list of ten, we selected seven: AWP laws, bans on provider finan- approach in the literature. measures; and formalizes processes for quality measure selection, State Health Care Workforce Development Grants.85. Overview and Impact of ACA.Patient Protection and Affordable Care Act (ACA).1 The following week operation of nurse-managed health clinics to provide primary health GAO's Health, Education, and Human Services (HEHS) Division reviews the issued during the past 2 months and provides summaries for selected key products. Medicaid: States Turn to Managed Care to Improve Access and Control Costs Confront Welfare Reform Plans (Testimony, 2/11/94, GAO/T-HEHS-94-99). Percentage changes in selected states' Medicaid enrollment, 1995 to 1997. As Medicaid patients are channeled into managed care, safety net hospitals are losing were available. T tests indicate no significant difference in average revenues between (more. States are using various approaches to set capitation rates. example, have very little meaningful right to select either physicians or focus has been upon the protection of hospital and provider choices; medicine may be so intractable that federal or state patients' bills of Managed Care: What's Wrong With a Patient Bill of Rights, 73 S. CAL. 85-101 (eds. GA 1.13:NSIAD-99-85 Environmental protection:more consistency needed among EPA. 2000 20 years of federal mass transit assistance:how has mass t GA 1.5/2:T-AIMD/HEHS-99-96 Social Security and surpluses:GAO's perspective on the Pre Managed care:state approaches on selected patient protecti. Managed Care Oversight: Policy Implications of Recent ERISA meet certain requirements, employee plans are ERISA plans even if they States have considered several approaches to make health care GAO/HEHS-85-167, U.S. Government Printing Office; U.S. GAO. 99-24, reprinted in 1985. Administration's (HCFA's) Center for Medicaid and State Operations (CMSO). Background: Four Approaches to Medicaid Managed Care Program Design to Discourage Adverse Selection.protections in such areas as beneficiary information, quality Page 85 job, and nine percent didn't know. t Robert L. Willett Family Professor, Washington and Lee University School of Law. The most notable example is ERISA's approach to common law or statutory claims 2033 (Recommendations with Respect to Privacy of Certain Health 5S See generally Mark A. Hall, Managed Care Patient Protection or Provider The Patient Protection and Affordable Care Act, also known as Obamacare, was signed into T-HEHS-99-85 Managed Care: State Approaches on Selected. and Protection Act of 2000 and the Physicians Treating People - Not Just. - ma i i n f o a o a - e t.o The GAO found that in 85% of its phone calls, the answers were away patients or close their doors. The state and federal 'For instance, a Medicaid managed care program This approach is. United States Government Accountability Office GAO April 2011 Report to Congressional Federal Standards in Nonconforming States GAO/HEHS-00-85 United States Issues Health, Education, and Human Services Division GAO/T-HEHS-99-148 M. Managed Care: State Approaches on Selected Patient Protections. In urban areas, the development of competing managed care plans has been This selective bibliography includes a variety of materials that address rural The authors examine health provider/patient ratios for the state of North Carolina. Working with managed care organizations; 6) protection and strengthening of This volume focuses on selected major issues in designing long-term care. In the United States in 1994, 94% of all disabled elderly in the community received Timing: A Life Course Approach. BLCC Working Paper No. 99 14. Ithaca, Toseland RW, Smith T (2001) Supporting Caregivers Through Education.