Medicare Health Maintenance Organizations: The IMC Experience : Hearing Before a Subcommittee of the Committee on Government Operations, House of Representatives, One Hundredth Congress, First Session, December 15, 1987, Volume 4U.S. Government Printing Office, 1988 - 205 pages |
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Page 27
... tell you the truth , to come up with an exact number . We worked with the Health Care Fi- nancing Administration in trying to fix the exact amount owed by IMC to the Federal Government , but we had problems with the exact evidence . But ...
... tell you the truth , to come up with an exact number . We worked with the Health Care Fi- nancing Administration in trying to fix the exact amount owed by IMC to the Federal Government , but we had problems with the exact evidence . But ...
Page 30
... Tell us what that is about ? Mr. KUSSEROW . Well , you are not supposed to have a bias in the selection of enrollees . We have figured out - the Department has figured out what the costs of servicing beneficiaries are likely to be , but ...
... Tell us what that is about ? Mr. KUSSEROW . Well , you are not supposed to have a bias in the selection of enrollees . We have figured out - the Department has figured out what the costs of servicing beneficiaries are likely to be , but ...
Page 32
... tell us if it were isolated to certain affiliates that were independent , what would it tell us about the whole network of IMC . So , we thought that the better way to go was to take a stratified sample of all en- rollees in IMC and to ...
... tell us if it were isolated to certain affiliates that were independent , what would it tell us about the whole network of IMC . So , we thought that the better way to go was to take a stratified sample of all en- rollees in IMC and to ...
Page 35
... tell you , I am a native son of the golden West and my par- ents both belong to Kaiser , which is an HMO in California . My dad , about a year and a half ago , had a stroke , which is diagnostic related group No. 14 , which was very ...
... tell you , I am a native son of the golden West and my par- ents both belong to Kaiser , which is an HMO in California . My dad , about a year and a half ago , had a stroke , which is diagnostic related group No. 14 , which was very ...
Page 38
... tell you , I don't sleep easy about it . Mr. SAWYER . I wasn't suggesting that . Mr. KUSSEROW . But you did hit some sense of guilt on my part , and I think it is right . And I am agreeing with you in the sense that it seems to me that ...
... tell you , I don't sleep easy about it . Mr. SAWYER . I wasn't suggesting that . Mr. KUSSEROW . But you did hit some sense of guilt on my part , and I think it is right . And I am agreeing with you in the sense that it seems to me that ...
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Expressions et termes fréquents
50 percent affiliated providers agency asked audit Chairman complaints concern conflict of interest Congressman correct costs counties Dade County DATE ACTIVITY December 15 decision demonstration employees enrollees enrollment standard fact Federal qualification Financing Administration Florida former HHS FOWLER freedom-of-choice George Reeb going GOULET HADDOW HCFA Health and Human Health Care Financing Health Maintenance Organizations Heckler HMO's hospital Human Services IMC contract IMC's inspector International Medical Centers investigation issue Jeb Bush Juan del Real Kevin Moley kind KUSSEROW law firm letter LIGHTFOOT Lyn Nofziger Medicaid Medicare beneficiaries Medicare contract Medicare enrollment Medicare Program ment Miami Miguel Recarey million MOLEY non-Medicare OHMO operations paid patient payment PELOSI PRIVATE HEALTH PLANS problems PRUSSIN qualification officer Recarey's received recommendations regulations requirement responsibility risk-based SAWYER staff statement subcommittee TEFRA terminate testimony Thank things tion waiver Wayne Fowler WEISS
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Page 97 - Did you have a statement that you would like to make? STATEMENT OF ROBERT F.
Page 72 - Mr. Chairman, this concludes my statement and I will be pleased to answer any of your questions.
Page 6 - THE SUBCOMMITTEE ON HUMAN RESOURCES AND INTERGOVERNMENTAL RELATIONS OF THE COMMITTEE ON GOVERNMENT OPERATIONS HOUSE OF REPRESENTATIVES FEBRUARY 18, 1988 Mr.
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Page 85 - Mr. Chairman, this concludes my statement. I will be pleased to respond to any questions that you may have at this time.
Page 117 - ... organization's enrollment may be Medicare and Medicaid beneficiaries. (2) Waiver of composition of enrollment standard. Unless limited by the criteria specified in paragraph (d)(3) of this section, HCPA may waive compliance with the requirements of paragraph (d)<l) of this section if— (i) The organization is making reasonable efforts to enroll individuals who are not Medicare or Medicaid beneficiaries; and (ii) Medicare and Medicaid beneficiaries constitute more than 50 percent of the population...
Page 158 - ... this subcommittee the benefit of your experience and programs. We appreciate your being a witness. At this point I would like to have entered into the record a statement by Senator Bellmon. He was not able to get here to present it in the opening, so it will be entered into the record in its entirety. STATEMENT OF HON. HENRY BELLMON, A US SENATOR FROM THE STATE OF OKLAHOMA Senator BELLMON. Mr. Chairman, members of the subcommittee : At the outset I want to say how pleased I am that this special...
Page 158 - DIRECTOR, OFFICE OF HEALTH MAINTENANCE ORGANIZATIONS, DEPARTMENT OF HEALTH AND HUMAN SERVICES; AND HAROLD HUNTER, DIRECTOR, RESEARCH AND DEVELOPMENT, GROUP HEALTH ASSOCIATION OF AMERICA Mr.
Page 89 - I appreciate your taking the time to testify before the Government Operations Human Resources and Intergovernmental Relations Subcommittee on December I5.