N.J. plan would let only physicians deny HMO care

Article Abstract:

New Jersey health officials have proposed new rules that would require health maintenance organizations (HMOs) to permit physicians to decide on medical treatments for HMO patients. Under the proposed rules, HMOs would have to get state recertification every three years, be audited by the National Committee for Quality Assurance, and pay a security deposit to cover possible liquidation costs. The new rules also would consider a new performance reporting system for HMOs and allow patients to appeal HMO decisions to an independent utilization-review organization.

Health Maintenance Organizations, HMO Medical Centers, New Jersey. Department of Health

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Caring for the children; senior citizens throw lobbying weight behind kids' coalition

Article Abstract:

The American Association of Retired Persons has formed Generations United along with the Children's Defense Fund and other groups to promote universal health care access and coverage for US children. Children's health care issues are beginning to gain attention in the Clinton administration, especially since funding for children's medical care programs was overlooked in the 1980s. Only one in three children in the US receive medical coverage. By contrast, most senior citizens are covered by Medicare.

Health aspects, United States, Children, Social policy, Health insurance, Child health, AARP, Children's Defense Fund

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War stories: state medical societies share lobbying tips

Article Abstract:

The Patient Protection Act (PPA) topped the list of priorities at the state medical society lobbyists' 1995 roundtable. A formidable lobbying force, the medical societies nonetheless faced a formidable opposition to PPAs from employers in 1994. On the Medicaid reform front, the societies are at the very least seeking greater state accountability for the programs. Another big issue is potential abuses springing from any-willing-provider laws.

Direct Health and Medical Insurance Carriers, Prepaid Provider Health Plans, Health care industry, Political aspects, Associations, Managed care plans (Medical care)

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