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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…
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July 23, 2013
Consumer-Oriented Approaches to Problem Solving in Medicaid Managed Care
Jane Perkins Issue Brief
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July 23, 2013
New Mexico Supreme Court Requires Medicaid to Cover All Medically Necessary Abo
External Source Issue Brief
NM Supreme Court Requires Medicaid to Cover All Medically Necessary Abortions January 1999 The New Mexico Supreme Court has ruled that the State must cover all medically necessary abortions in its Medicaid program using State-only funds. While federal Medicaid dollars are available to pay for abortions…
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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…
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July 23, 2013
Reproductive Health Services and Expansion of Religious Health Entities: Bill I
dfitzgerald Issue Brief
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July 23, 2013
Model Managed Care Complaint Process (revised May ’99)
Jane Perkins Issue Brief
This model complaint procedure supercedes earlier versions. This process is intended for use in state-based managed care programs, particularly Medicaid and child health insurance programs. But, it can be adapted to other managed care situations as well. Many of the provisions are taken from existing state managed care rules…
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Model Medicaid Managed Care Contract Provisions — Medical Necessity Definition

Consumer-Oriented Approaches to Problem Solving in Medicaid Managed Care

New Mexico Supreme Court Requires Medicaid to Cover All Medically Necessary Abo

Catholic Health Systems Getting Bigger

Reproductive Health Services and Expansion of Religious Health Entities: Bill I

Model Managed Care Complaint Process (revised May ’99)