In 1997, HHS published its first strategic plan in response to the Government Performance and Results Act (GPRA). Since that time, the Department has successfully implemented the remaining GPRA requirements and now is working to continually improve the quality of its GPRA submissions. Part of that quality improvement effort has focused on updating
 In addition to the reforms noted, as per the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), all health insurance contracts for employer-groups of 2-50 employees must be issued on a guarantee-issue basis.
National Association of Health Underwriters State Level Individual and Small Group Market Health Insurance Reforms March 2007
The nongroup (individual) health insurance market provides access to coverage for persons who cannot obtain health insurance coverage through their employer or do not qualify for public programs. For some persons it provides a temporary source of coverage while between jobs or for early retirees who are not yet eligible for Medicare.
States, in their actions, can and do make very different decisions about how to regulate the individual health insurance market. These actions reflect different values, political climates, and expectations. They also are designed to achieve specific policy goals, such as expanding access, with most states having considered laws and/or regulati
The previous sections of this report describe some of the types of regulations that states can implement in their governance of the individual insurance market. However, within each of the major areas of regulation there is wide variation in the requirements that have been implemented. For example, within a rating structure that may be imposed
States have issued other types of regulations to ensure access to the individual private health insurance market. Among the more common are pre-existing condition limitations and medical loss ratios.
A handful of states have enacted rating reforms for the individual health insurance market, prohibiting or restricting insurers from charging higher premiums based on health status or the risk of having future medical claims. These rating restrictions are generally of two types: rate bands and community/adjusted community rating.
States have sought to improve access to insurance policies through several regulatory approaches.
Every state has adopted certain basic standards for health insurance that apply to all types of health insurance products. These standards protect consumers by requiring insurers to be financially solvent and capable of paying claims, pay claims promptly, and adhere to certain market conduct requirements. Regulation begins with the licensing o
The business of insurance, including health insurance, has traditionally been regulated at the state level. States license entities that offer health insurance coverage and have established laws that control their structure, finances, and obligations to the people that they insure. However, a number of federal laws also have an impact on priva
A Description of Board and Care Facilities, Operators, and Residents. 6.5 Health Status and Health Care Use
Over one-third of all board and care residents self-report poor or fair health. As shown in Exhibit 6-6 , the most prevalent health problem was arthritis/rheumatism, reported by 42 percent of residents. High blood pressure (28 percent), diabetes (11 percent), and asthma, emphysema, or chronic bronchitis (11 percent) were other frequently mentione
State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Aspects of Washington's Quality Improvement Program that Work Well
The QAN program is based on the concept that survey agency staff members can establish supportive, professional relationships with nursing facility leaders so that facility staff can be kept informed about potential compliance issues that are observed. Feedback from the Washington providers with whom we spoke suggests that the state has been effec
State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Aspects of Texas's Quality Improvement Programs Noted to be Less Successful
During our visit we heard several concerns from provider representatives, particularly regarding the Quality Monitor Program. Many of these less positive comments appear to have been influenced by differences of opinion regarding the type of technical assistance that DHS should be giving providers under the new program. Some had expected that the
State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Impetus for Missouri's Quality Improvement Programs
The QIPMO programs originated from the vision of Marilyn Rantz and supporters at the Division of Aging. Dr. Rantz holds a Ph.D. in Nursing from the University of Wisconsin-Milwaukee, Masters of Science in Nursing from Marquette University, and Master of Arts in Teaching from the University of Wisconsin-Whitewater. She has also been a nursing home
State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Summary/Conclusions
The project team was impressed with the level of support that most QIPs received from the various providers that participated in our discussions. The general attitude expressed was that most of the QIPs introduced in the Nursing Home Reform package were feasible, appropriately directed, and able to be implemented by most (if not all) nursing facil