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Consumer Protection Issues in Medicare + Choice

This report describes and analyzes key Medicare+Choice provisions in the Balanced Budget Act and the accompanying regulations related to consumer protections. It explains how the BBA makes significant improvements for beneficiaries in the areas of access, appeals, and quality. It also explores areas that could be strengthened to better serve…

External Review of Health Plan Decisions in the States and Medicare – Report

External Review of Health Plan Decisions:An Overview of Key Program Features in the States and MedicareExternal Review of Health Plan Decisions:An Overview of Key Program Features in the States and MedicarePrepared for the Kaiser Family Foundation by:Karen Pollitz, M.P.P., Geraldine Dallek, M.P.H., and Nicole Tapay, J.D.Institute for Health Care Research…

External Review of Health Plan Decisions in the States and Medicare

An analysis of the external review process, the formal dispute resolution process established by state or federal agencies, independent of disputing parties, that has the capacity to evaluate and resolve at least those disputes involving medical issues. This paper identifies critical features of external review systems in thirteen states and…

Managed Care Consumer Protections Offered by Medium and Large Employers

A fact sheet summarizing data from a survey conducted between January and March of 1998 with 1,583 firms with 200 or more workers. The survey, which is conducted annually, focuses on the characteristics of the health benefit plans sponsored by employers.The supplemental questions discussed in this brief were developed jointly…

Managed Care Consumer Protections Offered by Medium and Large Employers – Fact Sheet

Managed Care Consumer Protections Offered by Medium and Large EmployersNovember 1998BackgroundDuring the past year, Congress and the states considered a number of proposals that would have provided additional protections to consumers in health insurance plans, particularly managed care plans. Among the key issues raised in these debates was how much…

Kaiser/Harvard Survey of Americans on the Consumer Protection Debate

The survey was designed and analyzed by researchers at the Kaiser Family Foundation and Harvard University; and was conducted by telephone by Princeton Survey Research Associates with 1,200 adults, 18 years or older, nationwide, between August 6 and August 20, 1998.

Protection For Consumers In Managed Care Plans: A Comparison Of Medicare, Medicaid and the Private Insurance Market

This policy paper describes key requirements of consumer protection regulation under Medicare, Medicaid and federal and state laws as they apply to private health insurance. These include choice and availability of plans, disclosure of information, marketing, access, quality, and the grievance and appeals process. The discussion highlights differences and similarities…