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Medicaid
Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by U.S. state, state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding. States are not required to participate in the program, although all have since 1982. Medicaid was established in 1965, part of the Great Society set of programs during Presidency of Lyndon B. Johnson, President Lyndon B. Johnson’s Administration, and was significantly expanded by the Affordable Care Act (ACA), which was passed in 2010. In most states, any member of a household with income up to 138% of the federal Poverty line in the United States#Measures of poverty, poverty line qualifies for Medicaid coverage under the provisions of the ACA. A 201 ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Affordable Care Act
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and informally as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with amendments made to it by the Health Care and Education Reconciliation Act of 2010, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare (United States), Medicare and Medicaid in 1965. Most of the act remains in effect. The ACA's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20 to 24 million additional people covered. The law also enacted a host of Healthcare industry#Delivery of services, delivery system reforms intended to constrain healthcare costs and improve quality. After it came into effect, increases in overall ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicare (United States)
Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with End Stage Renal Disease Program, end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). It started in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS). Medicare is divided into four parts: A, B, C and D. Part A covers hospital, skilled nursing, and hospice services. Part B covers outpatient services. Part D covers self-administered prescription drugs. Part C is an alternative that allows patients to choose private plans with different benefit structures that provide the same services as Parts A and B, usually with additional benefits. In 2022, Medicare provided health insurance for 65.0 million individuals—more than 57 million people aged 65 and older and about 8 million younger people. According to annual Medicare ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Children's Health Insurance Program
The Children's Health Insurance Program (CHIP) – formerly known as the State Children's Health Insurance Program (SCHIP) – is a program administered by the United States Department of Health and Human Services that provides matching funds to states for health insurance to families with children. The program was designed to cover uninsured children in families with incomes that are modest but too high to qualify for Medicaid. The program was passed into law as part of the Balanced Budget Act of 1997, and the statutory authority for CHIP is under title XXI of the Social Security Act. CHIP was formulated in the aftermath of the failure of President Bill Clinton's comprehensive health care reform proposal. First Lady Hillary Clinton's brainchild in the aftermath of the failing of passage of her healthcare reform work, this Legislation to create CHIP was co-sponsored by Democratic Senator Ted Kennedy and Republican Senator Orrin Hatch. Despite opposition from some conservatives ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Centers For Medicare And Medicaid Services
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States. This includes mai ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicaid Managed Care
Medicaid managed care Medicaid and additional services in the United States through an arrangement between a state Medicaid agency and managed care organizations (MCOs) that accept a set payment – "capitation" – for these services. As of 2014, 26 states have contracts with MCOs to deliver long-term care for the elderly and individuals with disabilities. There are two main forms of Medicaid managed care, "risk-based MCOs" and "primary care case management (PCCM)." Managed care delivery systems grew rapidly in the Medicaid program during the 1990s. In 1991, 2.7 million beneficiaries were enrolled in some form of managed care. Currently, managed care is the most common health care delivery system in Medicaid. In 2007, nearly two-thirds of all Medicaid beneficiaries are enrolled in some form of managed care – mostly, traditional health maintenance organizations (HMO) and primary care case management (PCCM) arrangements. This amounted to 29 million beneficiaries, of which 19 mil ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Administrator Of The Centers For Medicare & Medicaid Services
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States. This includes maintain ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicaid Drug Rebate Program
The Medicaid Drug Rebate Program is a program in the United States that was created by the Omnibus Budget Reconciliation Act of 1990 (OBRA'90). The program establishes mandatory rebates that drug manufacturers must pay state Medicaid agencies related to the dispensing of outpatient prescription drugs covered by Medicaid. To participate in the program, drug manufacturers must have a National Drug Rebate Agreement with the Secretary of the Department of Health and Human Services (HHS). As of 2020, approximately 600 pharmaceutics companies participated in the Medicaid Drug Rebate Program. Rebate amounts are confidential under section 1927(b)(3)(D) of the Social Security Act. The Medicaid Drug Rebate Program also provides for savings in other Federal health care programs. Signing the National Drug Rebate Agreement also requires drug manufacturers to enter into agreements for the 340B Drug Pricing Program as well as the Federal Supply Schedule. Rebate methodology The Medicaid Drug ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Mehmet Oz
Mehmet Cengiz Oz ( ; ; born June 11, 1960), also known as Dr. Oz (), is an American television presenter, physician, author, educator and government official serving as the 17th administrator of the Centers for Medicare & Medicaid Services since 2025. The son of Turkish immigrants, Oz was raised in Wilmington, Delaware, and graduated from Harvard University and the University of Pennsylvania. A Multiple citizenship, dual citizen of the United States, U.S. and Turkey, Oz completed 60 days of mandatory military training in the Turkish Land Forces, Turkish Army during the 1980s. He subsequently began his residency in surgery at Columbia University Irving Medical Center in 1986. In 2001, Oz became a professor of surgery at Columbia University, and later retired to professor emeritus in 2018. In May 2022, the institution dissafilliated with Oz and removed his presence from their website. In 2003, Oprah Winfrey was the first guest on the Discovery Channel series ''Second Opinion wi ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Managed Care Organization
In the United States, managed care or managed healthcare is a group of activities intended to reduce the cost of providing health care and providing health insurance while improving the quality of that care. It has become the predominant system of delivering and receiving health care in the United States since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010. ...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, s ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Great Society
The Great Society was a series of domestic programs enacted by President Lyndon B. Johnson in the United States between 1964 and 1968, aimed at eliminating poverty, reducing racial injustice, and expanding social welfare in the country. Johnson first used the phrase in a May 7, 1964, speech at Ohio University. The Great Society sought to build on the legacy of former President Franklin D. Roosevelt's New Deal reforms of the 1930s, and planned to use the power of the federal government in order to address Income inequality in the United States, economic inequality, improve education and healthcare, and promote Civil rights movement, civil rights. The post–World War II economic expansion had raised living standards for many Americans, but significant disparities remained, particularly for racial minorities and those living in impoverished rural and urban areas. The civil rights movement was gaining momentum, highlighting Institutional racism, systemic racism and discrimination. ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Insurance Premium Payment Program
The Health Insurance Premium Payment Program (HIPP) is a Medicaid program that allows a recipient to receive free private health insurance paid for entirely by their state's Medicaid program. A Medicaid recipient must be deemed 'cost effective' by the HIPP program of their state. Ultimately, the program was made optional, and its use is minimal. The Omnibus Budget Reconciliation Act of 1990 (OBRA-90) authorized states to implement an HIPP program. HIPP is for families who have at least one person who gets Medicaid and can get private insurance through a family member's work. As of 2008, relatively few states had premium assistance programs, and enrollment was relatively low. Interest in this approach remained high, however.Joan Alker"CHOOSING PREMIUM ASSISTANCE: WHAT DOES STATE EXPERIENCE TELL US?,"The Kaiser Family Foundation, May 2008 In some states the HIPP program has been institutionalized by non profit organizations to assist Medicaid recipients with the difficult task of ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
