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California Department Of Managed Health Care
The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, sometimes referred to as Health Maintenance Organizations (HMOs) in California. The DMHC was created as the first state department in the country solely dedicated to regulating managed health care plans and assisting consumers to resolve disputes with their health plans. The DMHC Help Center educates consumers about their health care rights, resolves consumer complaints, helps consumers navigate and understand their coverage and assists consumers in getting timely access to appropriate health care services. The DMHC Help Center provides direct assistance in all languages to health care consumers through the Department’s website, www.HealthHelp.ca.gov, and a toll-free phone number, 1-888-466-2219. Mary Watanabe is currently the director of the DMHC. The DMHC is part of the California Health and Human Services Agency. It was established in 2000 and is responsible for enforcing ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Managed Health Care
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving American health care 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 ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Managed Care
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving American health care 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 p ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Managed Care
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving American health care 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 p ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
California Code Of Regulations
The California Code of Regulations (CCR, Cal. Code Regs.) is the codification of the general and permanent rules and regulations (sometimes called administrative law) announced in the ''California Regulatory Notice Register'' by California state agencies under authority from primary legislation in the California Codes. Such rules and regulations are reviewed, approved, and made available to the public by the Office of Administrative Law (OAL), and are also filed with the Secretary of State. The CCR consists of 28 titles and contains the regulations of approximately 200 regulatory agencies. Title 24, the California Building Standards Code, is not maintained by the OAL but by the California Building Standards Commission. It has been alleged that the regulations have substantial portions under copyright (''e.g.'', Title 24, the California Building Standards Code), but Title 24, California Code of Regulations, though administered and authored by the Building Standards Commission o ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Healthcare In California
This article summarizes healthcare in California. California State Department of Health Care Services The California Department of Health manages state government projects in California. Health insurance As of 2018, most of the insured in California were in plans regulated by the California Department of Managed Health Care (DMHC) with about 60% regulated by either DMHC or the California Department of Insurance (CDI). This dual regulation arose due for historical reasons, and when the DMHC was created in 2000, the California legislature requested a report on merging the health insurer responsibilities with the CDI. Dual regulation has also raised questions around the applicability of premium tax to the DHMC-regulated entities, which have historically not paid premium taxes while CDI-regulated entities have. Value-based pay for performance managed care plans where providers take on risk have arisen, and in 2019 the DHMC announced plans to regulate these "risk-bearing entities ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Kaiser Permanente
Kaiser Permanente (; KP), commonly known simply as Kaiser, is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser Permanente is made up of three distinct but interdependent groups of entities: the Kaiser Foundation Health Plan, Inc. (KFHP) and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the regional Permanente Medical Groups. As of 2017, Kaiser Permanente operates in eight states (Hawaii, Washington, Oregon, California, Colorado, Maryland, Virginia, Georgia) and the District of Columbia, and is the largest managed care organization in the United States. Kaiser Permanente is one of the largest nonprofit healthcare plans in the United States, with over 12 million members. It operates 39 hospitals and more than 700 medical offices, with over 300,000 personnel, including more than 87,000 physicians and nurses. Each Permanente ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Maintenance Organization
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status. Operation HMOs often require members to select a primary care ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
California Department Of Corporations
The California Department of Corporations (DOC) was a department within the former California Business, Transportation and Housing Agency in California. The chief officer of the Department was the Commissioner of Corporations. Effective July 1, 2013, the Department of Corporations and the Department of Financial Institutions became divisions of the California Department of Business Oversight (DBO) pursuant to the Governor's Reorganization Plan No. 2 of 2012. History The Department of Corporations was originally known as the "State Corporation Department" and was created by the "Investment Companies Act". Governor Hiram Johnson appointed H.L. Carnahan as California's first Commissioner of Corporations in 1914. The Investment Companies Act faced immediate opposition but was approved by the voters in a 1914 referendum. In 1917, the legislature enacted the Corporate Securities Act. The combination of the Department of Corporations and the Department of Financial Institutions was ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
United States Department Of Labor
The United States Department of Labor (DOL) is one of the executive departments of the U.S. federal government. It is responsible for the administration of federal laws governing occupational safety and health, wage and hour standards, unemployment benefits, reemployment services, and occasionally, economic statistics. It is headed by the Secretary of Labor, who reports directly to the President of the United States and is a member of the president's Cabinet. The purpose of the Department of Labor is to foster, promote, and develop the well being of the wage earners, job seekers, and retirees of the United States; improve working conditions; advance opportunities for profitable employment; and assure work-related benefits and rights. In carrying out this mission, the Department of Labor administers and enforces more than 180 federal laws and thousands of federal regulations. These mandates and the regulations that implement them cover many workplace activities for about 10 ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Maintenance Organization
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status. Operation HMOs often require members to select a primary care ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Employee Retirement Income Security Act Of 1974
The Employee Retirement Income Security Act of 1974 (ERISA) (, codified in part at ) is a U.S. federal tax and labor law that establishes minimum standards for pension plans in private industry. It contains rules on the federal income tax effects of transactions associated with employee benefit plans. ERISA was enacted to protect the interests of employee benefit plan participants and their beneficiaries by: * Requiring the disclosure of financial and other information concerning the plan to beneficiaries; * Establishing standards of conduct for plan fiduciaries; * Providing for appropriate remedies and access to the federal courts. ERISA is sometimes used to refer to the full body of laws that regulate employee benefit plans, which are mainly in the Internal Revenue Code and ERISA itself. Responsibility for interpretation and enforcement of ERISA is divided among the Department of Labor, the Department of the Treasury (particularly the Internal Revenue Service), and ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
California Insurance Commissioner
The California insurance commissioner has been an elected executive office position in California since 1991. Prior to that time, the insurance commissioner was appointed by the governor. The officeholder is in charge of the California Department of Insurance. The current insurance commissioner is Democrat Ricardo Lara. Duties * Oversees and directs all functions of the Department of Insurance. * Licenses, regulates, and examines insurance companies. * Answers public questions and complaints regarding the insurance industry. * Enforces the laws of the California Insurance Code and adopts regulations to implement the laws. * The mission is to ensure vibrant markets where insurers keep their promises and the health and economic security of individuals, families, and businesses are protected. Office As a result of the passage of Proposition 103 in 1988, the elected office of the California Insurance Commissioner was created in 1991. Previously, the position was held by a pe ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
