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Managed Care Law 1999

Author: Molly Stauffer

Publisher: Aspen Publishers

Published: 1998-10-16

Total Pages: 238

ISBN-13: 9780735502130

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.

Law and Practice of Private Health Insurance and Managed Care

Author: Christian Funk

Publisher: diplom.de

Published: 2000-04-28

Total Pages: 147

ISBN-13: 3832423214

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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 [...]

State-by-State Laws and Regulations on Workers' Compensation Managed Care

Author: Jane M. Anderson

Publisher: Jones & Bartlett Learning

Published: 1999

Total Pages: 120

ISBN-13: 9780834216051

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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.

Guide to State Medicaid Managed Care Laws and Rules

Author: Jane M. Anderson

Publisher: Jones & Bartlett Learning

Published: 1999

Total Pages: 98

ISBN-13: 9780834216068

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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.

Strangers in the Night

Author: Peter D. Jacobson

Publisher: Oxford University Press

Published: 2002-08-08

Total Pages: 497

ISBN-13: 0190288299

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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

Publisher: Aspen Publishers

Published: 1999-12-01

Total Pages: 368

ISBN-13: 9780735504905

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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 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 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 Law 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.

Managed Care

Author:

Publisher: Jones & Bartlett Learning

Published: 1998

Total Pages: 184

ISBN-13: 9780834211209

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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

Author:

Publisher:

Published: 2004

Total Pages: 702

ISBN-13:

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State by State Guide to Managed Care Law, 2014 Edition

Author: John F. Buckley

Publisher: Wolters Kluwer Law & Business

Published: 2013-11-12

Total Pages: 548

ISBN-13: 9781454825807

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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

Publisher: Aspen Publishers

Published: 2002-12-10

Total Pages: 656

ISBN-13: 9780735532212

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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.