Choosing a Health Plan: Providing Medicare Beneficiaries With the Right Tools, Hearing Before the Special Committee on Aging, U.S. Senate
Charles E. Grassley
DIANE Publishing, Dec 1, 1998 - Consumer education - 135 pages
Witnesses: Michael Hash, deputy admin., Health Care Financing Admin.; William Scanlon, dir., Health Finance & System Issues, GAO; Susan Kleimann, Kleimann Communications Group; Geraldine Dallek, project dir., Inst. for Healthcare Research & Policy, Georgetown Univ.; David Abernethy, sr. v.p., Public Policy & Regulatory Affairs, HIP Health Plans. Also, materials submitted by: Nat. Assoc. of Area Agencies on Aging; Nat. Asian Pacific Center on Aging; Rivet Hand Rehab. Center; Cong. Research Serv. ; U.S. Dept. of HHS; 8 Key Components of the 1998 Nat. Medicare Educ. Program (NMEP); Challenges for the NMEP; & NMEP Budget.
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$3 per visit 190 lifetime days Abernethy admitted $20 Agencies on Aging Area Agencies assistance Balanced Budget Act Center Chairman charge no charge Charles Grassley cognitive map Committee on Aging comparative information contract costs counseling covered in full Dallek David Abernethy disenrollment rates enrollment ensure fee-for-service plan Financing Administration focus groups full unlimited days funding going handbook Hash HCFA HCFA's Health Care Financing Health Insurance Health Maintenance Organizations health plan options help beneficiaries ICA programs informed choice Internet John Breaux mailing managed care plans marketing materials Medical Savings Account Medicare beneficiaries Medicare Education Program Medicare HMOs Medicare individuals Medicare Managed Medicare population Medicare program Medicare+Choice plans Medicare+Choice program Medigap million National Medicare Education organizations out-of-pocket costs percent Preferred Provider Organizations prescription drug questions Scanlon Senator Breaux Senator Wyden seniors toll-free traditional Medicare understand waived if admitted
Page 3 - 55 members are the chief insurance regulatory officials of the 50 states, the District of Columbia, and four US Territories. The NAIC's Special Committee on Health Insurance is composed of 41
Page 125 - 1998 TO : Senate Special Committee on Aging FROM : Kathleen S. Swendiman Legislative Attorney American Law Division SUBJECT : Authority Under the Balanced Budget Act of 1997 to Require Standardized Formats For Medicare+Choice Program Marketing Materials and Application Forms This responds to your request for a legal analysis of the authority of the Secretary of the Department of
Page 126 - In that decision the Supreme Court upheld the validity of Department of Labor regulations issued under the black lung benefits program. The Court stated that "(w)hen Congress, through express delegation or the introduction of an interpretive gap in the statutory structure, has delegated policy-making authority to an administrative agency, the extent of judicial review of the agency's policy determinations is limited."
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Page 21 - and I am pleased to report that we have made significant progress since
Page 56 - Medicare Managed Care 1997 Benefits Comparison Chart — Northern California, HCFA. beneficiaries under the original medicare fee-for-service program and the Medicare+Choice program and the right to be protected against discrimination based on health status-related factors under section 1852(b). (D) INFORMATION ON MEDIGAP AND MEDICARE
Page 56 - coinsurance, and copayment amounts, and (iii) any beneficiary liability for balance billing. (B) ELECTION PROCEDURES- Information and instructions on how to exercise election options under this section. (C) RIGHTS- A general description of procedural rights (including grievance and appeals procedures) of 7 Irwin Kirsch, Ann Jungebluf, Lynn Jenkins, and Andrew Kolstad, Adult Literacy in America, National Center for Education Statistics, Office of Educational Research and Improvement, 1993, pl 17.
Page 47 - Mr. SCANLON. We would agree wholeheartedly. I believe that we can only benefit by competition and that genuine competition where plans are having to compete on the basis of the quality and the value of the services they offer is something that is going to improve the health care that is available in the market.
Page 18 - Mr. HASH. I think we should talk with you and your staff about that and see where—in case we are not already doing that or do not have an access point for those kinds of people, particularly isolated, rural beneficiaries, because we would like to provide a better access for information for them as well.