Individual: any natural person who is a past, present, or proposed named or principal insured (including any principal insured under a family or group policy or similar arrangement of coverage for a person in a group), policyowner, or past or present claimant. Insurance Institution:
The Commission's approach to the problems described in this chapter has been to focus on strengthening and balancing the relationship between the individual insurance applicant, policyholder, or claimant and the insurance institution with whom he deals. As indicated at the outset, the Commission's recommendations have three objectives: (1) to c
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Impact on Quality of Care
The PERT studied the effect of parity on quality of care for adults by using established standards of care for treating specific disorders, i.e., depression and substance abuse, to create indicators of quality following the methods developed by several investigators (c.f. Berndt et. al 1997; Lehman and Steinwachs, 1998). The methods described in t
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Impact on Access to Care, Service Use, and Cost
Implementing parity required changing the nominal benefits for coverage of treating mental health and substance abuse (MH/SA) disorders. The dimensions of the nominal benefit that are most often affected when parity policies are implemented are:
Evaluation of Parity in the Federal Employees Health Benefits (FEHB) Program: Final Report. Implementation Case Studies
Using case study methods, PERT investigators characterized the structure and process employed by OPM and each of the eight selected plans to implement the FEHB Program parity requirement. The case studies focused on effective as well as nominal benefits, and described:
Persons With Mental Retardation and Related Conditions in Mental Retardation Facilities: Selected Findings from the 1987 National Medical Expenditure Survey. Resident Characteristics
The following tables present data on a range of diagnostic, medical and functional skills of residents of mental retardation facilities grouped by type of operation, ICF-MR certification status, and facility size. The estimates are from the Baseline Questionnaire. Level of Retardation/Type of Related Conditions
Standards for Privacy of Individually Identifiable Health Information. Final Privacy Rule Preamble.. Privacy is Necessary to Secure Effective, High Quality Health Care
While privacy is one of the key values on which our society is built, it is more than an end in itself. It is also necessary for the effective delivery of health care, both to individuals and to populations. The market failures caused by the lack of effective privacy protections for health information are discussed below (see section V.C below). H
Background/Objectives We interviewed the following individuals during our site visit to Washington State: Dorothy Canavan, Lab Manager, Dynacare Jon Counts, Dr.P.H., Director, Public Health Laboratories Jac Davies, Health Services Administrator, Public Health Laboratories Daniel Jernigan, Medical Epidemiologist, Public Health Laborator
As the private sector counterparts to PHLs, and also as an increasing source of competition, private clinical laboratories are a central element of the PHL operating environment.
Each state’s reporting requirements identify certain individuals who are required to notify the authorities of suspected abuse. Although it varies by state, mandated reporters are typically individuals who encounter children through their professional capacity . In Pennsylvania, the statute requires all individuals who encounter a case of abu
Overview Adult day health care (ADHC) providers in New Jersey (NJ) are licensed by the state Department of Health and Senior Services Division of Long Term Care Systems under NJ Administrative Code (NJAC) , Chapter 8:43F, whose provisions are summarized in this profile.
Overview All facilities offering adult day or adult day health care (ADHC) must be licensed by the Bureau of Licensure and Certification in the Department of Human Resources Division.
Overview Adult day care centers that are funded by the Office of Services to the Aging (OSA) are not licensed. The OSA provides Operating Standards for Service Programs to be followed by providers of services to older persons in Michigan. Services may be provided only under an approved area plan through a formal contractual agreement between t
Overview Adult day care and adult day health care (ADHC) are regulated by the state Cabinet for Health and Family Services. The Division of Aging Services certifies facilities for the Adult Day Care and Alzheimer's Respite program, which is governed under Kentucky Administrative Regulations 910 KAR 1:160 and 1:230.
Overview The Arkansas Office of Long Term Care in the Department of Human Services licenses adult day care (ADC) and adult day health care (ADHC) under separate rules and regulations. Arkansas provides ADC and ADHC under the ElderChoices Medicaid waiver and requires providers to be licensed. Licensure and Certification Requirements
Regulatory Review of Adult Day Services: Final Report SECTION 2. STATE REGULATORY PROFILES