State to push separate AIDS patient HMOs program
The state plans to fund specialized AIDS networks within HMOs to manage care for Medicaid patients with HIV. It aims to pay monthly per patient, offset by non-AIDS enrollees, and to have networks in place by next summer. Community groups suggest hospital and doctor ties, not HMOs, may lead AIDS care.
MENTIONED IN THIS ARTICLE
Douot
Sand Hope Pravin
Rogram Mananar Fine
Shy Aids Inctitatom
New York
Hvcs
EAMES
Hmos
Amber Smith
AANOs cut deals with labs hurting doctors patients
In a shift toward managed care, AANOs push patients to specific laboratories, driving down prices but lifting costs for doctors who lose freedom to choose labs. MetroHealth labs process hundreds of thousands of tests yearly, with savings cited but doctors complain of paperwork and loss of in-office testing.
Onondaga County Closes Public Clinics for Poor
Tuesday report states Onondaga County ends public clinic services for the poor amid a shift in medical help policy. The Fraldal Journal notes officials cited budget constraints and reorganized health aid programs affecting low income residents.
MENTIONED IN THIS ARTICLE
Onondaga County
State forces HMOs to enroll more poor patients
State officials backed a capitation payment plan to enroll Medicaid recipients, arguing reimbursement rates fail to cover costs. HMOs faced penalties for shortfalls, with Health Services Medical Corp losing $770,528 and HMO-CNY $1 million in 1995 after short enrollments.
MENTIONED IN THIS ARTICLE
Hmos
Health Services Medical Corp
HMO (Hat
State Insurance Department
Hmo-Cny
MVP Health Plan
New York Penalizes HMOs for Medicaid Shortfalls Since 1992
New York State has penalized HMOs about 50 million dollars since 1992 for insufficient Medicaid patient care. HMOs agreeing to Medicaid care earned a 9 percent discount on hospital rates, with penalties replacing all or part of the discount if care for Medicaid patients was lacking. From 1992 to June 1996, Central New York plans including Healthsource, MetraHealth, and PHP administered by Health Services Medical Corp faced penalties, while Syracuse area MOOs had none in early 1996. Source: NYS Department of Health.
MENTIONED IN THIS ARTICLE
Onondaga County
Barbara DeBuono
Jennifer Daniels
Aft
Syracuse
Mediseva
Mike McLean
Health Services Medical Corp
Jef Snewer
Onondara County
Better Health Plan
Larough Maren
Department of Social Services
Groundnc
Durham
United States
HMO
Total Care
Syracuse Community Health Center
Healthsource
Harms of Healthsource
Hmos
Diane Green-Elis
Xetv
York
HAMO
McLean
State Health Department
New York State
New York
Travelers
MetraHealth
United Healthcare
Syracuse-area
NYS Department of Health
Herkimer
Little Falls Hospital
MVP Health Plan
MVP Plan
Steven Johnson
Mylania
Maalox
MVP
Johnson
RomeHnenital
Medicare Moves Toward HMO Style Managed Care
Medicare policymakers press doctors to steer patients to hospitals with discount programs for orthopedic and heart surgeries. A pioneering emphysema surgery was cut due to unestablished long term benefits. Cataract removals were halted unless medically necessary, while New Yorks Empire Blue Cross redefined medical necessity last spring. Ambulance reimbursements seek over 100 million from 1991 to 1944 as rules deny payment when patients can reach an ambulance themselves. An insurer serving Medicare counties develops its own audit program after NYC issues problems.
MENTIONED IN THIS ARTICLE
Medicare
Health Care Financing Administration
Empire Blue Cross
Blue Shield
New York City
Cig
Who
HMOs curb emergency visits hit hospitals hard
The piece reviews how Medicaid HMOs like Total Care in Syracuse require prior approval for ER visits, leading to unpaid bills when patients misjudge emergencies. It highlights Daniel Crough’s study of 222 Total Care patients at University Hospital, findings on lack of working phones, and ethical issues. It also cites patient appeals to MVP Health Plan over denied ER claims for ear infections and abdominal pain, illustrating payer resistance and doctor lobbying.
MENTIONED IN THIS ARTICLE
Daniel Crough
University Hospital
Syracuse
Crough
Health Science Center
Alay
Manhasset
Rough
George Pa
Total Care
Syracuse Community Health Center
Hmos
Hann Aianunertad
HMO
American College of Erergench Physicians
Wappinger Falls
Medicus
MVP
Jeter
Also Mentioned on This Page
Speor
Zetia
Bletrateattn
Cortungath
Southkhine Beecham Clinical Laboratories
MetroHealth
Dave Barker
Metraneotta
Viet- Path Out
Ferald- Journal
HMO Conference
U.S. Supreme Court
Tom D'Angelo
Communicalams
Diane Greenel
Miya Littleton
Miya
Tammy Rice
Gary Waltsysis Proneg Oun
Michael
Capital District
Albany
Healthshield
Cigna Healthplan
Empire
Naira Health Services Medical
Hill
Ind
Health Assoc
Hudson
WNY
Kaiser Foundation Health Pi Motite Healthcare
Mid Hudson Health
Pia Avp Health Plus
Oxford Health Tans
Cho
Physicians Health
Prudential Hearthen
Sanu
Travelers Health
US Healthcare
Counties
Omia Hel
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