Author archive for dfitzgerald

Clear Filters

… results.

July 23, 2013
EPSDT Update For Child Health Insurance and Medicaid Advocates
dfitzgerald Issue Brief
November 20, 1997 Prepared by Jane Perkins, Lourdes Rivera, and Kristi Olson--National Health Law Program Abigail English and Catherine Teare--National Center for Youth Law The Medicaid program, through its Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit package, requires states to provide comprehensive preventive, acute,…
Read more
July 23, 2013
Model Medicaid Managed Care Contract Provisions — Third Party Beneficiaries
dfitzgerald Issue Brief
NHeLP Model Medicaid recipients enrolled in managed care are the intended third-party beneficiaries of contracts between the state and MCOs and of any subcontracts or provider agreements entered into by MCOs with subcontracting providers and, as such, enrollees are entitled to the remedies accorded to…
Read more
July 23, 2013
Model Medicaid Managed Care Contract Provisions — Member Advocates
dfitzgerald Manual/Report
NHeLP Model Member Advocate Requirements -- The health plan must employ one or more member advocate(s), as specified in section 3(c) below, during the entire contract term. The member advocate(s) will work with enrollees, providers, and plan personnel to facilitate the provision of Medicaid benefits…
Read more
July 23, 2013
Model Medicaid Managed Care Contract Provisions — Medical Necessity Definition
dfitzgerald Issue Brief
Introduction The definition of "medical necessity" raises two general issues of concern to consumers: What benefits are covered? (E.g., are they limited to diagnosis and treatment, or do they also include preventive care? Are experimental services excluded? Does the definition recognize and mandate the…
Read more
July 23, 2013
NHeLP Comments: Medicare + Choice Interim Final Regulations Pertaining to Repro
dfitzgerald Comments
Read more
July 23, 2013
Catholic Health Systems Getting Bigger
dfitzgerald Issue Brief
Catholic Health Systems Getting Bigger April 1999 Catholic Institutions alone control 600 hospitals, 140,000 hospital beds, and $40 billion in revenue. Columbia/HCA, one of the nation?s largest for-profit and secular systems controls 300 hospitals, 60,000 beds and $14.5 billion in revenue. In 1997, four of…
Read more

Author archive for dfitzgerald

Never miss a thing.

Subscribe today.

EPSDT Update For Child Health Insurance and Medicaid Advocates

Model Medicaid Managed Care Contract Provisions — Third Party Beneficiaries

Model Medicaid Managed Care Contract Provisions — Member Advocates

Model Medicaid Managed Care Contract Provisions — Medical Necessity Definition

NHeLP Comments: Medicare + Choice Interim Final Regulations Pertaining to Repro

Catholic Health Systems Getting Bigger