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Section 1115 Research & Demonstration Projects: States can apply for program flexibility to test new or existing approaches to financing and delivering Medicaid and CHIP. Section 1915(b) Managed Care Waivers: States can apply for waivers to provide services through managed care delivery systems or otherwise limit people's choice of providers.
Such coding is necessary for Medicare, Medicaid, and other health insurance programs to ensure that insurance claims are processed in an orderly and consistent manner. Initially, use of the codes was voluntary, but with the implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) use of the HCPCS for ...
Before the spread of health insurance, doctors charged patients according to what they thought each patient could afford. This practice was known as sliding fees and became a legal rule in the 20th century in the U.S. [ 7 ] [ 10 ] Eventually, changing economic conditions and the introduction of health insurance in the mid-20th century ushered ...
Like QSEHRAs, ICHRAs can help reimburse the cost of tax-free health insurance premiums. An ICHRA can help cover the cost of an employee's health insurance premium, and the employee can choose what ...
Those who are "medically indigent earn too much to qualify for Medicaid but too little to purchase either health insurance or health care." [3] Medically indigent people with significant illnesses face several barriers to health insurance. States like South Carolina came up with their own MIAP program to assist those who fall in the gaps. [4]
Diagnosis-related group (DRG) is a system to classify hospital cases into one of originally 467 groups, [1] with the last group (coded as 470 through v24, 999 thereafter) being "Ungroupable". This system of classification was developed as a collaborative project by Robert B Fetter, PhD, of the Yale School of Management , and John D. Thompson ...
Starting Jan. 1, older adults on Medicare will spend no more than $2,000 a year on prescription drugs when a new price cap on out-of-pocket payments from the Inflation Reduction Act goes into effect.
This is a KFF Health News story. Preparing cancer patients for difficult decisions is an oncologist's job. At the University of Pennsylvania Health System, doctors are nudged to talk about a ...