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SMI Trust Fund: Estimates under Alternative II Assumption for Aged and Disabled Excluding End-Stage Renal Disease Enrollees
through an independent reporting system. In a health care program with continuously increasing incurred reim- ... them to the time of service. 3) Managed Care Services Managed care plans with contracts to provide health ...- Authors: Society of Actuaries
- Date: Oct 2000
- Competency: External Forces & Industry Knowledge
- Publication Name: Pension Section News
- Topics: Public Policy; Social Insurance
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Effects of Consumerism & Regulation on the Health Insurance Industry in Canada and the United States
business that I work in and we have closed off our Direct Individual Medical Expense line at the beginning ... closed our individual medical expense business to direct sales. In states where we were forced to issue ...- Authors: Willis W Burgess, D Wayne Carstens, Raymond L Whaley, Lear P Wood
- Date: Jun 1979
- Competency: External Forces & Industry Knowledge>External forces and business performance
- Publication Name: Record of the Society of Actuaries
- Topics: Health & Disability>Health insurance; Public Policy
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Issue Brief: Changing Financial Risks for Medigap Insurance, Part 2
(snowbirds, for example); and cover their major health care needs without MA’s utilization reviews and the risk ... as well as likely delays in receiving necessary care.[4] Providers may also appreciate Medigap-covered ...- Date: Mar 2024
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health insurance; Public Policy; Public Policy
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Session 020: Provider Reimbursement and Mental Health Parity
closely follow federal law. The Sherman Act, is the primary U.S. antitrust law pertaining to association activities ... NQTLs directly relate to plan’s payments to health care providers: • Coding Edits • UCR Determination ...- Authors: Kristi Bohn, Rebecca Owen, Irvin Muszynski
- Date: Jan 2020
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Health & Disability; Public Policy; Health & Disability>Provider networks
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Implementing Parity: Investing in Behavioral Health—Part 1
providers, and consumers of behavioral health care. Part 1 of this article will address implementation ... could impact the busi- ness of behavioral health care and the decisions that follow is of even greater ...- Authors: Stephen P Melek
- Date: May 2010
- Competency: External Forces & Industry Knowledge
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Public Policy
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Effect Of New Federal Policies On Medical Insurance
the Medicare and Medicaid prograns affect medical care cost inflation for employers and insurers? Indeed ... cost shifting refers to the practice by medical care pr_iders to offset the reduced levels of income ...- Authors: Carl L Loeffel, Gordon R Trapnell, Theodore Allison
- Date: Apr 1982
- Competency: External Forces & Industry Knowledge
- Publication Name: Record of the Society of Actuaries
- Topics: Public Policy
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ACLI Update: Update on Noncoordinated Benefits
like copays, deductibles, and travel for medical care. The policies pay a fixed dollar amount on the occurrence ... spouse or dependents for the prescribed medical care are excludable from gross income. Does not make ...
- Authors: Sarah Lashley, Regina Y Rose, Mandana Parsazad
- Date: Oct 2023
- Competency: External Forces & Industry Knowledge
- Publication Name: Taxing Times
- Topics: Health & Disability; Health & Disability>Accident insurance; Health & Disability>Critical illness insurance; Health & Disability>Health care quality; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy; Public Policy; Health & Disability>Affordable Care Act (ACA)
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Future of Government Programs
Economist of the Office of the Actuary of the Health Care Financing Administration (HCFA). His current areas ... Economist of the Office of the Actuary of the Health Care Financing Administration in Baltimore, Maryland ...- Authors: Gordon R Trapnell, Stanley B Jones, Randy L Teach, Mark Freeland
- Date: Apr 1987
- Competency: External Forces & Industry Knowledge
- Publication Name: Record of the Society of Actuaries
- Topics: Public Policy
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Medicare Reform: What Has Happened and What Can Happen?
Rick Foster. He is the chief actuary of the Health Care Financing Administration (HCFA) and a former deputy ... & Young, he has been involved directly in health care, and, of course, Medicare has been a big part of ...- Authors: Richard Foster, Roland E King, Harry L Sutton, Frederick B Abbey
- Date: Oct 1996
- Competency: External Forces & Industry Knowledge
- Publication Name: Record of the Society of Actuaries
- Topics: Public Policy; Social Insurance>Medicare
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Session 169: Risk Adjustment in Medicaid: Recent Developments
Consulting Group in 2012 • Principal in Denver Office – Primary focus on Government Programs with emphasis on ... allocate capitated payments between contracted managed care organizations Source: ResDAC Medicaid Risk Adjustment ...- Authors: Edward M Mailander, Daniel Henry
- Date: Feb 2020
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Health & Disability; Health & Disability>Payment models; Public Policy; Public Policy