Medscape Summary

There are major challenges faced by policy makers such as trying to control the cost of Medicaid spending because Medicaid is the biggest payer of these services. Policy makers must ensure that they are also keeping the individual served front and foremost in their decisions. Ensuring that quality services are met is one piece of the puzzle. As stated, unfortunately it seems that those who have lesser insurance or who cannot afford these services are provided with less than

The Centers for Medicare & Medicaid Services (2010) states that the federal government in conjunction with the Affordable Care Act (ACA) are pushing for the integration of behavioral health care and primary care for individuals with serious mental illness (SMI).

Policy analysis of mental health care under the ACA as well as description of how mental health care/service are organized under the ACA from federal to local levels.

Regardless of where one stands, one must admit that the American economy is not thriving. Not only is it not thriving, but also the American economy has either been in depression or on the verge of depression for the last decade. Because of this, parity seems to be a dream. It is not the prime time to push for the ACA, perhaps during the 80’s or 90’s, but there were other political dilemmas that needed to be dealt with. Another factor to take into account is the reaction of the healthcare system once it truly has to cover for mental illness treatment. Because there is an immense amount of cost, around $131,000(Abelson), to

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is an act that requires parity or equality between mental health treatment and medical/surgical treatment covered by private and public insurers with over 50 employees. That means that if an insurance covers mental health issues they can’t impose more stringent limits and financial requirements than medical/surgical coverage. The act was signed into law in 2008 by President George W. Bush. Before the act was signed into law, mental health care was not as affordable or accessible for individuals. (United States Department of Labor, 2016)

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted on October 3, 2008 as sections 511 and 512 of the Tax Extenders and Alternative Minimum Tax Relief Act of 2008. MHPAEA amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHS Act), and the Internal Revenue Code of 1986 (Federal Register, 2013). The MHPAEA is an extension of the Mental Health Parity Act of 1996, which prohibited annual or aggregate lifetime financial limits on mental health coverage by addressing other restrictions, such as limits on outpatient visits or inpatient days (DOL, 2010). MHPAEA expands parity requirements to treatment limitations, financial requirements, and in- and out-of-network covered benefits (Smaldone, 2010). It also expands the opportunity of mental health parity requirements at the federal level and includes substance use disorders within its scope. Prior to 1996, health insurance coverage for mental illness had historically been less generous than that of other physical illness (Sarata, 2011). Mental health parity is a response to this disparity in insurance coverage, and generally refers to the concept that health insurance coverage for mental health services should be offered equally with covered medical and surgical benefits (Smaldone, 2010).

In 2010, the Affordable Care Act invoked a $75 millon dollar demonstration project known as the Medicad Emergency Psychiatric Demonstration that was amended in section 2707 of the Affordable Care Act (ACA). The change seemed to be just what the nation needed, however, there was fine print added to the amendment that changed the interpretation. The fine print stated, patients who are on Medicaid from the ages of 21-65 seeking inpatient mental health care can receive treatment under the law. However, the inpatient facility will receive no

With the rollout of the Medhost MU stage 2 products, it became immediately evident that changes would need to be made in the application to improve physician acceptance and adoption. Medhost created the Physician Advisory Board (PAB) to define the changes and create an experience “designed by doctors for doctors”. Both Dr. Hussain and Dr. Stepansky participated on this board to ensure that CHS’ needs would be heard by Medhost. This redesigned product, Medhost 2014 R2, contained a newly redesigned order management system along with version 1 of physician “favorites”.

I was disturbed by the article I read on Medscape because many lives were affected by this physician action. Dr. Fata is an oncologist practicing in Detroit, Michigan who became rich administering excessive or unnecessary chemotherapy to hundreds of patients even to those individuals who did not have cancer (Lowes, 2015). According to federal prosecutors, the excessive and unnecessary treatment, which went beyond chemotherapy was part of a massive criminal scheme that netted at least $17 million from Medicare and private insurers (Lowes, 2015). Dr. Fata performed each actions deliberately which was unethical. He took an oath to provide prudent care to the public which he fail short doing by affecting 553 patients. Besides affecting those individuals

In 2017, Nebraska installed a new program to better administer its Medicaid program. Since its launch, the system has left behavioral health and home health providers fuming over unpaid claims and frustrated about getting care authorized for patients (citation). Unpaid Medicaid claims topped $300,000 for one agency, prompting it to take out a line of credit for the first time in its 44 years and providers are worried about how long they can afford to keep seeing Medicaid patients (citation). Most of the problems being reported are among behavioral health and home health care providers, but others have experienced difficulties as well, including one rural hospital whose payment check from one of the Medicaid managed care companies bounced (citation). Patients are being severely affected, as they aren't taking the necessary medications because they aren't being authorized. In some cases, patients have had to extend their hospital time because therapy was also not being authorized in a shortly manner. Nebraska authorities have suggested that claim payments should speed up and that they problem will resolve in the

The passage of the 2008's Mental Health Parity and Addiction Equity Act was one of the most important moment's in the history of rehabilitation treatment because it made it mandatory for health insurance providers to provide rehabilitation coverage. United Healthcare was one company that really embraced this change by creating United Behavioral Health, a sub-set of United Healthcare that is designed to treat addiction, among many other health concerns.

There are federal and state laws that are in place for your protection. All Medigap policies, clearly identified as “Medicare Supplement Insurance,” should be structured in accordance with these laws. Moreover, the insurance companies offering Medigap plans are allowed to sell only standardized policies identified in many states by

The CEO of the San Francisco, California medical imaging, teleradiology, and telemedicine company Medweb, Dr. Pete Killcommons is also an industry expert and international philanthropist who travels the world to help and advise telemedicine initiatives in developing nations. In November of 2010, Mr. Killcommons traveled to Podgorica, Monte Negro to lecture at the Fourth Intensive Balkan Telemedicine and e-Health Seminar.

There are a few different government funded health care programs that are provided to a different group of Americans. One of the insurance programs provided by the government is Medicaid. Medicaid is a federal and state program which covers the cost of medical care for people who are considered to have an income that is lower than a certain level. The people who are accepted to receive Medicaid are those who are low income families with children, recipients receiving benefits for Supplemental Security Income, women who are pregnant and their income is lower than federal poverty guidelines along with the infants born to the women who are Medicaid eligible. Those who have Medicaid have to locate doctor 's offices who accept Medicaid as one cannot use this insurance anywhere. The government should provide health care for health care has been overly priced to almost impossible to afford; the number of uninsured residents has grown significantly; and with the government providing health care the physicians wouldn 't have to worry about how they would be getting paid they would be able to focus on helping the person get better.

Managed care is simply a system that delivers health care to a specific population purchased though health insurance plans. It is an approach to financing and delivering health care that seeks to control costs and ensure or improve quality of care through a variety of methods, including provider network management, utilization management, and quality assurance. Patients agree to visit only certain doctors and hospitals, which a managing company monitors the cost of the treatment. Managed care has been introduced as a way to bring equality for health care utilization by ensuring those receiving the treatment actually need it, based on their symptoms and seriousness of injury. The managed care industry has made undeniable impacts in nearly every aspect of the health-care industry. Mental healthcare workers have endured drastic changes in their clinical practice. George H. Northrup a physician in mental health, talks about the uprising crisis in mental health care and how it has to do with money. In past years psychologists set fees based on their training and experience, and health insurance companies typically reimbursed patients a portion of that amount. But mental health benefits are now “managed” patients may be restricted to doctors in the insurance company’s network, and doctors who want to be in the network must accept drastically reduced fees. These changes have affected how healthcare administrators and clinical practitioners perceive the impact of managed care on