The Agency for Health Care Administration (AHCA) is a regulatory agency in Florida which was created under the Health Care Reform Acts of 1992. The purpose of the Health Reform Acts of 1992 was to ensure efficient quality and affordable health care services were available to all Floridians by the end of 1994. Florida, in the 1980’s, had a very large population of uninsured residents and a large population of senior citizen, practically all of whom are insured by Medicare; and its Medicare expenditures per eligible beneficiary were the highest in the nation (Florida Agency For Health Care Administration). The AHCA was statutorily created by Chapter 20.42 of the Florida Statutes and is the main health policy and planning unit for the entire state. The head of the department is the Secretary of Health Care Administration, who is appointed by the Governor and subject to confirmation by the Senate. The secretary reports directly to the Governor (Florida Agency For Health Care Administration). The Legislative Affairs Office is the AHCA’s resource for legislative collaboration and provides information to legislators and the public about health care legislation. It helps in the drafting of new legislation, synchronizing briefings, providing assistance to legislators and promoting the AHCA’s agenda during the legislative process. The agency’s primary responsibility is to be the chief health policy and planning entity for the state. The department is responsible for health facility licensure, inspection, and regulatory enforcement; investigation of consumer complaints related to health care facilities and managed care plans; the implementation of the certificate of need program; the operation of the Florida Center for Health Information a... ... middle of paper ... ...process” whenever benefits are denied, condensed, or dismissed. The Supreme Court has defined essential components of due process for Medicaid to include: prior written notice of adverse action, a fair hearing before an impartial decision-maker, continued benefits pending a final decision, and a timely decision measured from the date the complaint is first made. Works Cited http://kff.org/other/navigating-medicare-and-medicaid-medicaid-online-version/ http://ahca.myflorida.com/medicaid/about/about2.shtml http://www.benefits.gov/benefits/benefit-details/1625 Kaiser Family Foundation, 2013hca http://www.heritage.org/research/reports/2011/11 http://www.fdhc.state.fl.us/Executive/Inspector_General/ http://www.floridahealth.gov/public-health-in-your-life/administrative-functions/inspector-general/ ahca.myflorida.com/executive/communications/legislative.shtml
What is HIPAA? The Health Insurance Portability & Accountability Act of 1996 (HIPAA) was passed by the U.S. Congress to improve portability and continuity of health insurance coverage; to combat waste, fraud and abuse in health insurance; to reduce costs and the administrative burdens by improving efficiency and effectiveness of the health care system by standardizing the interchange of electronic data; and to ensure the pri...
It is enthralling to note that in spite of the advances in healthcare systems, such as our hospital’s ability to provide patients with lower cost, managed One being the Health Maintenance Organizations (HMO), which was first proposed in the 1960s by Dr. Paul Elwood in the "Health Maintenance Strategy”. The HMO concept was created to decrease increasing health care costs and was set in law as the Health Maintenance Organization Act of 1973, after promotion from the Nixon Administration. HMO would, in exchange for a fee, allow members access to employed physicians and facilities. In return, the HMO received market access and could earn federal development funds.
Health Insurance Portability and Accountability Act or HIPAA is a statute endorsed by the U.S. Congress in 1996. It offers protections for many American workers which improves portability and continuity of health insurance coverage. The seven titles of the final law are Title I - Health care Access , Portability, Title II - Preventing Health Care Fraud and Abuse; administrative simplification; Medical Liability Reform; Title III – Tax-related Health Provisions; Title IV – Application and Enforcement of Group Health Plan Requirements; Title V – Revenue Offsets; Title XI – General Provisions, Peer Review, Administrative Simplification; Title XXVII – Assuring Portability, Availability and Renewability of Health Insurance Coverage. (Krager & Krager, 2008)
In 2010, the passage of the Patient Protection and Affordable Care Act (PPACA) initiated reforms between healthcare and healthcare providers. For example, Huntsville Hospital Health System developed as smaller healthcare providers sought refuge under Huntsville Hospital’s larger umbrella. Nine separate campuses, among the North Alabama area, constitute the Huntsville Hospital Health System
Healthcare in the U.S. has recently been affected by implementation of the Affordable Care Act (ACA) of 2010. The intent is to create a healthca...
“Health and Human Services, United States Department of, federal executive department charged with administering government health programs. Successor to the Department of Health, Education, and Welfare, which had been created in 1953, it was redesigned in 1979 wi...
The United States (U.S.) has a health care system that is much different than any other health care system in the world (Nies & McEwen, 2015). It is frequently recognized as one with most recent technological inventions, but at the same time is often criticized for being overly expensive (Nies & McEwen, 2015). In 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) (U. S. Department of Health & Human Services, n.d.) This plan was implemented in an attempt to make preventative care more affordable and accessible for all uninsured Americans (U.S. Department of Health & Human Services, n.d.). Under the law, the new Patient’s Bill of Rights gives consumers the power to be in charge of their health care choices. (U.S. Department of Health & Human Services, n.d.).
A very notable goal is to make healthcare affordable for all Americans and at the same, improving the quality and efficiency in which healthcare is conducted. Many look at this act and notice the key benefits that are provided for all Americans, and are interested to find other improvements that help everyday ...
In 1965 President Johnson signed both Medicare and Medicaid programs into law (Nile, 2011). According to Medical news today, “Medicare is a social insurance program that serves more than 44 million enrollees as of 2008” (MediLexicon International Ltd, 2011, para2). It cost about $432 billion or 3.2% of GDP, as of 2007(par2).Medicare is broken down into parts, Part A is hospital Insurance Part B is medical Insurance, and Part D is Medicare prescription drug coverage (medicare.gov). Like we previously stated Medicare is a health insurance for people who are 65 and older, people under 65 with certain disabilities, and people of any age with End- Stage Renal Disease. Medicaid is a joint federal-state program of medical assistance for low income persons (Benefit.gov). It is administered by the Illinois Department of Human Services (DHS) and Illinois Department of Public Aid (IDPA). Medicaid serves about 40 million people as of 2007; it cost $330 billion, or 2.4% of GDP, in 2007.(par.2) “In Illinois you may be eligible for Medicaid if you are a child, pre...
The beginnings of the Affordable Care Act started in 2008 when Barack Obama was running for president. He said “On healthcare reform, the American people are too often offered two extremes - government-run healthcare with higher taxes or letting the insurance companies operate without rules...I believe both of these extremes are wrong”. Obama won the Presidential election that November. In March of 2009 a “health summit” was brought together and Governor Kathleen
Medicaid supports children who are under the age of nineteen, people over the age of sixty five, enrollees who are disabled and those that need permanent nursing home care. Potential beneficiaries can find an application for Medicaid at their State’s Medicaid agency (Medicare.gov, 2008).
Pozgar, G.D. (2012). Legal Aspects of Health Care Administration. United States of America: Jones and Bartlett Learning, LLC.
Medicare and Medicaid are programs that have been developed to assist Americans in attainment of quality health care. Both programs were established in 1965 and are federally supported to provide health care coverage to vulnerable populations such as the elderly, the disabled, and people with low incomes. Both Medicare and Medicaid are federally mandated and determine coverage under each program; both are run by the Centers for Medicare & Medicaid Services, a federal agency ("What is Medicare? What is Medicaid?” 2008).
Barton, P.L. (2010). Understanding the U.S. health services system. (4th ed). Chicago, IL: Health Administration Press.
Health care policies are plans that intended to determine or influence decisions or actions that will help to achieve specific health care goals. Most of these policies are actions taken by the government to improve the American health care system. The purpose of this essay is to describe the process of how a topic eventually becomes a policy and tie to how the Affordable Health Care Act (ACA) policy process. This essay will include the formulation stage, legislative stage, and implementation stage of a complete policy process.