Who will regulate provider-run plans?

Article Abstract:

The federal government is debating the merits of three proposals to regulate provider-sponsored organizations (PSO). The American Medical Association and hospital lobbyists are pressuring Congress to develop national regulatory control of provider-run plans while states are waging a battle to shift PSO regulation to individual states. The debates are complicated by issues regarding how to categorize PSOs and who should maintain provider-run plans under prepaid Medicare contracts.

Medical Care Insurance, Health Regulation, Health care industry, Political activity, Managed care plans (Medical care), Medical law

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Medigap under fire: can it be fixed or should it be ditched?

Article Abstract:

Congressional and industrial factions are divided on the fate of the medigap insurance market. Economists and the American Medical Association believe that the system should be completely overhauled, while legislators and Pres Clinton favor allowing Medicare health maintenance organization enrollees to return to fee-for-service and purchase separate policies to cover the gaps in coverage. The insurance industry is poised to defend the medigap market.

Management, Clinton, Bill, Economic policy, United States. Congress, Medigap

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Senate bill boosts mental health coverage

Article Abstract:

The Senate has passed a provision which would prohibit employer health plans from placing caps on insurance coverage for mental illness which are less than caps for physical illness. The provision was authored by Sen Paul Wellstone and Sen Pete Domenici and received an 85-15 endorsement from the Senate. The bill is a scaled-back version of a similar bill which called for parity between benefits for mental and physical illness.

Administration of Public Health Programs, Mental Health Programs, Social policy, Mental health services, Mental illness, Mental disorders, United States. Congress. Senate, Insurance

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