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In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person's health insurance went into effect. Before 2014, some insurance policies would not cover expenses due to pre-existing conditions. These exclusions by the insurance industry were meant to cope with adverse selection by ...
The RAND Health Insurance Experiment (RAND HIE) was an experimental study from 1974 to 1982 of health care costs, utilization and outcomes in the United States, which assigned people randomly to different kinds of plans and followed their behavior. Because it was a randomized controlled trial, it provided stronger evidence than the more common ...
In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. [ 1 ][ 2 ] Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance ...
Mississippi has improved some of its poor health outcomes, but its people are more likely to die unnecessarily than residents of any other state. Mississippi has the highest rate of preventable ...
The Medicare for All Act (abbreviated M4A ), also known as the Expanded and Improved Medicare for All Act or United States National Health Care Act, is a bill first introduced in the United States House of Representatives by Representative John Conyers (D-MI) in 2003, with 38 co-sponsors. [ 1][ 2] In 2019, the original 16-year-old proposal was ...
The Mississippi Senate passed a bill Wednesday that would streamline the process for doctors in the state to receive prior authorization on procedures from insurance companies.
As for the bit items on lawmakers' agendas, education, Medicaid, the state's retirement plan and even online gambling are just a few of the more than 200 bills still being considered by state ...
Utilization management. Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria or guidelines.