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An HMO may also contract with an existing, independent group practice ("independent group model"), which will generally continue to treat non-HMO patients. Group model HMOs are also considered closed-panel, because doctors must be part of the group practice to participate in the HMO - the HMO panel is closed to other physicians in the community.
The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs).
In 1993, Version 2.0 of HEDIS was known as the "Health Plan Employer Data and Information Set". [2] Version 3.0 of HEDIS was released in 1997. [ 1 ] In July 2007, NCQA announced that the meaning of "HEDIS" would be changed to "Healthcare Effectiveness Data and Information Set."
An HMO Point-of-Service (HMO-POS) plan is a type of HMO plan. With an HMO-POS plan, an individual must choose a PCP, but they can use out-of-network services at a higher cost, similar to a PPO plan.
This year, open enrollment for public health insurance plans begins Nov. 1, 2024, and closes on Jan. 15, 2025. During the open enrollment period, Americans have the option to enroll, renew, or ...
2.3 Health insurance (major medical insurance) 2.3.1 Medicare. 2.4 Workers' compensation. 3 See also. 4 References. Toggle the table of contents.
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