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Upper Payment Limits
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Book Synopsis Crs Report for Congress by : Congressional Research Service: The Libr
Download or read book Crs Report for Congress written by Congressional Research Service: The Libr and published by BiblioGov. This book was released on 2013-11 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: In accordance with Medicaid statute, the Secretary of Health and Human Services (HHS) has established, through a series of regulatory actions, upper payment limits (UPLs) for inpatient and outpatient services provided by certain types of facilities. In late 2000, the Secretary determined that regulations in effect at that time created a financial incentive for states to make higher than usual payments for care provided at non-state government facilities, namely, county and city facilities, allowing these states to claim higher federal matching dollars. States require these facilities to transfer some or all of the excess funds back to the state. Then states use these funds to cover part of the state share of Medicaid costs and/or for other purposes. After HHS issued a proposed rule in October of 2000 designed to halt these practices, Congress mandated additional changes to upper payment limits in the Benefits Improvement and Protection Act of 2000 (BIPA; incorporated by reference into P.L. 106-554). Final regulations that included the BIPA provisions were released by the Clinton Administration on January 12, 2001. Among other changes, this rule established a separate UPL for inpatient services provided by non-state government facilities, and for the subset of non-state public hospitals only, ...
Book Synopsis Medicaid Upper Payment Limits and Intergovernmental Transfers by : Elicia J. Herz
Download or read book Medicaid Upper Payment Limits and Intergovernmental Transfers written by Elicia J. Herz and published by . This book was released on 2002 with total page 17 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Upper Payment Limits by : United States. Congress. Senate. Committee on Finance
Download or read book Upper Payment Limits written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2001 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Upper Payment Limits by : Andy Schneider (J.D.)
Download or read book Upper Payment Limits written by Andy Schneider (J.D.) and published by . This book was released on 2002 with total page 17 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis UPPER PAYMENT LIMITS: FEDERAL MEDICAID SPENDING..., HEARING... S.HRG. 106-945... COMMITTEE ON FINANCE..., 106TH CONGRESS, 2ND SESSION... SEPTEM. by :
Download or read book UPPER PAYMENT LIMITS: FEDERAL MEDICAID SPENDING..., HEARING... S.HRG. 106-945... COMMITTEE ON FINANCE..., 106TH CONGRESS, 2ND SESSION... SEPTEM. written by and published by . This book was released on 2001* with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Upper Payment Limits by : United States. Congress. Senate. Committee on Finance
Download or read book Upper Payment Limits written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2001 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicaid Hospital Payment by : Jennifer Baldwin
Download or read book Medicaid Hospital Payment written by Jennifer Baldwin and published by . This book was released on 1991 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Update on the Implementation of the Average Manufacturers Price Upper Payment Limits for Pharmacy Reimbursement by : Colorado. Department of Health Care Policy and Financing
Download or read book Update on the Implementation of the Average Manufacturers Price Upper Payment Limits for Pharmacy Reimbursement written by Colorado. Department of Health Care Policy and Financing and published by . This book was released on 2008 with total page 5 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis 106-2 Hearing: Upper Payment Limits: Federal Medicaid Spending For Non-Medicaid Purposes, S. Hrg. 106-945, September 6, 2000 by :
Download or read book 106-2 Hearing: Upper Payment Limits: Federal Medicaid Spending For Non-Medicaid Purposes, S. Hrg. 106-945, September 6, 2000 written by and published by . This book was released on 2001 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicaid Upper Payment Limits and Intergovernmental Transfers by :
Download or read book Medicaid Upper Payment Limits and Intergovernmental Transfers written by and published by . This book was released on 2002 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In accordance with Medicaid statute, the Secretary of Health and Human Services (HHS) has established, through a series of regulatory actions, upper payment limits (UPLs) for inpatient and outpatient services provided by certain types of facilities. In late 2000, the Secretary determined that regulations in effect at that time created a financial incentive for states to make higher than usual payments for care provided at non-state government facilities, namely, county and city facilities, allowing these states to claim higher federal matching dollars. States require these facilities to transfer some or all of the excess funds back to the state. Then states use these funds to cover part of the state share of Medicaid costs and/or for other purposes. After HHS issued a proposed rule in October of 2000 designed to halt these practices, Congress mandated additional changes to upper payment limits in the Benefits Improvement and Protection Act of 2000 (BIPA; incorporated by reference into P.L. 106-554). Final regulations that included the BIPA provisions were released by the Clinton Administration on January 12, 2001. Among other changes, this rule established a separate UPL for inpatient services provided by non-state government facilities, and for the subset of non-state public hospitals only, a separate higher payment rate was allowed. It also provided a separate UPL for private facilities. Parallel rules were established for outpatient hospital and clinic services. Three phase-out or transition periods for states with enhanced payment arrangements that were noncompliant were also specified. Application of a specific transition period to a given state was primarily dependent on the effective date of its plan describing the enhanced payment arrangement. Phaseout periods varied in duration, and except for the shortest period, required specific percentage reductions in excess payments for each transition year. The Bush Administration made two changes to the Clinton final rule: (1) creation of a separate, minimum 1-year transition period for certain states that have only recently received approval for enhanced payment arrangements, and (2) elimination of the higher payment rate for non-state public hospitals. Several estimates of cost savings for federal Medicaid spending based on these changes to UPLs have been made. Over the next 10 years, savings associated with the January 12, 2001 final rule and BIPA range from $55 billion (Clinton Administration) to $77 billion (Congressional Budget Office or CBO), respectively. The 1-year transition period rule issued by the Bush Administration is expected to save $0.5 billion in FY2001 and FY2002. Elimination of the higher payment rate for city and county public hospitals is expected to save $9 billion over FY2002 through FY2006.
Book Synopsis Medicaid Eligibility Quality Control by : United States. Social and Rehabilitation Service
Download or read book Medicaid Eligibility Quality Control written by United States. Social and Rehabilitation Service and published by . This book was released on 1975 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Upper Payment Limits by : United States. Congress. Senate. Committee on Finance
Download or read book Upper Payment Limits written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2000 with total page 102 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Federalism and Health Policy by : Alan Weil
Download or read book Federalism and Health Policy written by Alan Weil and published by The Urban Insitute. This book was released on 2003 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.
Book Synopsis Report to the Legislature by : Minnesota. Health Care Administration
Download or read book Report to the Legislature written by Minnesota. Health Care Administration and published by . This book was released on 2006 with total page 8 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Medicare Laboratory Payment Policy by : Institute of Medicine
Download or read book Medicare Laboratory Payment Policy written by Institute of Medicine and published by National Academies Press. This book was released on 2000-12-04 with total page 261 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical laboratory tests play an integral role in helping physicians diagnose and treat patients. New developments in laboratory technology offer the prospect of improvements in diagnosis and care, but will place an increased burden on the payment system. Medicare, the federal program providing coverage of health-care services for the elderly and disabled, is the largest payer of clinical laboratory services. Originally designed in the early 1980s, Medicare's payment policy methodology for outpatient laboratory services has not evolved to take into account technology, market, and regulatory changes, and is now outdated. This report examines the current Medicare payment methodology for outpatient clinical laboratory services in the context of environmental and technological trends, evaluates payment policy alternatives, and makes recommendations to improve the system.
Author :American Bar Association. House of Delegates Publisher :American Bar Association ISBN 13 :9781590318737 Total Pages :216 pages Book Rating :4.3/5 (187 download)
Book Synopsis Model Rules of Professional Conduct by : American Bar Association. House of Delegates
Download or read book Model Rules of Professional Conduct written by American Bar Association. House of Delegates and published by American Bar Association. This book was released on 2007 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :0309468086 Total Pages :235 pages Book Rating :4.3/5 (94 download)
Book Synopsis Making Medicines Affordable by : National Academies of Sciences, Engineering, and Medicine
Download or read book Making Medicines Affordable written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-03-01 with total page 235 pages. Available in PDF, EPUB and Kindle. Book excerpt: Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
