...Children’s Health Insurance Program Tracy D Cotthoff Western Governors University Table of Contents Abstract 3 History of Children’s Health Insurance Program 4 The Impact of Licensure, Certification and/or Accreditation on CHIP 7 CHIP Reimbursement 8 Clinical Quality 9 Patient Access to CHIP 10 CHIP Impact on the Workforce 11 References 13 Abstract Americans have always had an insurance gap, but the hardest hit seem to be the children. There was a program created to try to fill that gap. Children’s Health Insurance Program was created to insure children that would otherwise be without health coverage. This program was started under Medicare to ensure that children would have medical, dental, vision, prescription, substance abuse and some mental benefits. History of Children’s Health Insurance Program The following is the history and facts of the Children’s Health Insurance Program: * In 1997, The Children's Health Insurance Program (CHIP) was created via federal law. For children’s families that have income above the Medicare limits, this program helps states to provide health insurance to uninsured, low-income children living with families. * The original CHIP funding for fiscal years 1998 thru 2008 was between $3.1 billion and $5.0 billion. The federal and state governments share in the cost for CHIP, and states have leeway in setting criteria for eligibility and which healthcare services to cover. * By 2007, 13 states had expanded...
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...CHIP Executive Summary HCS 550 June 30, 2014 CHIP Executive Summary The process of implementing a health care policy involves important steps of legislation formulation before execution and monitoring for progression and improvements. Committees and subcommittees on levels of the government, state, and local legislation are inclusive in ensuring the policy is enacted both efficiently and effectively. To accomplish these goals and objectives legislators must develop rules and regulations that align with goals and objectives, and take precautions to form the proper language to explain the actions suitable toward a successful operation. Some steps in the process are repeated each time a modification in the policy occurs. Examination of the Children’s Health Insurance Program (CHIP), justification of the policy, the responsibility of legislative committees appropriated to the policy, the implementation process, and the impact on the community, are addressed in the contents of this paper. CHIP Policy Description The Children’s Health Insurance Program (CHIP) provides low-income families with health coverage because they are not eligible for Medicaid. Funds for this program derive from state tax collections, and are matched by the federal government. Individuals under the age of 19 may receive coverage for immunizations, routine examinations, office visits, hospitalization, diagnostics, prescriptions, emergency room services, vision, and dental care. CHIP coverage...
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...Analysis Each state offers Medicaid and CHIP programs. There is approximately sixty million Americans with this health care coverage. Individuals with disabilities, parents, seniors, pregnant women and children are all eligible to receive the Medicaid plan. With federal minimum standards in place each state sets there individual criteria. Some federal laws in place are to cover certain population groups (mandatory eligibility groups) and gives them the flexibility to cover other population groups (optional eligibility groups). Medicaid, individuals must satisfy federal and state requirements regarding their current residency, immigration status, and documentation that they are a U.S. citizen. The Affordable Care Act of 2010 helped to expand Medicaid in 2014. “The Affordable Care Act provides Americans with better health security by putting in place comprehensive health insurance reforms that will: * Expand coverage, * Hold insurance companies accountable, * Lower health care costs, * Guarantee more choice, and * Enhance the quality of care for all Americans. Most recently, the MMA of 2003 included increases in DSH state allotments for 2004-2011 and added requirements for an independently certified annual audit. Figure 8.14 shows DSH funds as a percentage of the total Medicaid budget. The Affordable Care Act actually refers to two separate pieces of legislation — the Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and...
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...Health Care Reform for Children Valerie L. Briner HCAD 620 Professor Schutz Abstract Advancing toward universal health care has the possibility to improve access to care and better the health and wellbeing of uninsured children. This paper will discuss children and what medical coverage they may have and how healthcare reform should help get almost all children some type of healthcare. Currently, if a child is not covered under private insurance, Medicaid and CHIP can assist in covering the vulnerable groups, mostly because they are likely to be poor, belong to racial or ethnic minority groups or who have chronic health care problems. While both public and private insurance fail in meeting the needs of children, public coverage has been more persuasive than private coverage at providing managed health care to low-income children. Ideally health care reform could cause certain steps to promote the emotional, cognitive, and physical health of children, enable them to maximize their full potential. Such a focus would create application to such policy changes that could define solutions for failures in the current system and decrease discrepancy in access, quality, and outcomes. Healthcare Reform for Children The plan is set in place to overhaul the nation’s health care system. The goals of the health care reform proposals include moving the nation toward universal coverage, improving quality of care, and slowing the rate of...
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...TEMPLATE FOR CHILD HEALTH PLAN UNDER TITLE XXI OF THE SOCIAL SECURITY ACT CHILDREN’S HEALTH INSURANCE PROGRAM (Required under 4901 of the Balanced Budget Act of 1997 (New section 2101(b))) State/Territory:___________________________________________________________ (Name of State/Territory) As a condition for receipt of Federal funds under Title XXI of the Social Security Act, (42 CFR, 457.40(b)) ________________________________________________________________________ (Signature of Governor, or designee, of State/Territory, Date Signed) submits the following Child Health Plan for the Children’s Health Insurance Program and hereby agrees to administer the program in accordance with the provisions of the approved Child Health Plan, the requirements of Title XXI and XIX of the Act (as appropriate) and all applicable Federal regulations and other official issuances of the Department. The following State officials are responsible for program administration and financial oversight (42 CFR 457.40(c)): Name: Position/Title: Name: Position/Title: Name: Position/Title: *Disclosure. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 09380707. The time required to complete this information collection is estimated to average 160 hours per response, including the time...
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...for healthcare. The United States and Japan are two healthcare systems that are have different coverages for their citizens. United States: The United States has multiple opportunities for insurance coverage for people. There are many private insurance companies to insure Americans. There are also government assistant agencies such as: Medicare, Medicaid and Children Health Insurance Program (CHIP) (Commonwealth Fund, 2013). Persons must apply and qualify for any government assisted programs for healthcare. Medicaid: is offered to those who qualify with low income. (Families, individuals, and children) Medicare: is offered to those over the age of 65 years (retired) CHIP: is offered for children of modest level income families that do not qualify for Medicaid. Medications are covered by these groups with potential out-of-pocket expenses. Co-pays for medications are required. The type of medication may also be a factor. Some medications may not be covered by Medicaid, Medicare or CHIPS. There are times when a generic brand or alternate medication is encouraged to avoid a costly out-of-pocket expense to the patient. Social workers and physicians work together to find the most economical alternative to a medication. Specialists and/or physician referrals depends on the type of insurance plan you have. Medicare/Medicaid: HMO – requires a referral from your primary care provider. PPO – does not require a referral to see a specialist. CHIP – also requires a referral...
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...Health Law and Regulation-Medicaid and Medicare Mathew V Kurian HCS/545 November 5 2012 Pro. Maureen Lancellot Health Law and Regulation-Medicare and Medicaid Medicare and Medicaid, created by the Social Security Amendment Act 1965, added Title XVIII and XIX to the Social Security Act. President Lyndon B Johnson was responsible for bringing about this change. Social Security Program started during the Great Depression of 1930s because of the stock market crash and bank failure, which wiped away the retirement savings of the Americans. Poverty rate among senior citizen exceeded 50% during this time. Social Security Act was created in an attempt to limit the five dangers of modern American Society. The Social Security Act was signed by President Franklin D Roosevelt on August 14, 1935, thus becoming the first president to advocate federal assistance to the elderly. Edwin Witt, the executive director of the president committee on economic security is the father of Social Security. If the total benefit paid by social security in 1940 was $35 million, it was $247.8 billion in 1990, after 50 years. In 2009, about 51 million Americans received $650 billion benefits, under different social security programs like social security disability insurance (SSDI), supplemental security income (SSI), retirement insurance benefits (RIB), temporary assistance for the needy families, ticket to work and self-sufficiency program, unemployment benefit, State children’s health insurance...
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...and private providers. Most of the Medicare beneficiaries have to enroll in the MA program to help them to succeed and receive the adequate treatments without MA to help the disadvantaged seniors on the island, Puerto Rico's elderly citizens will be forced to turn to Mi Salud in larger numbers. Although Mi Salud is scheduled to receive an average of $690 million annually during the next five years, the widening deficit in MA funding is likely to create a net negative impact on federal funding for healthcare in Puerto Rico. The Health care Policies and Issues Ethical concerns and issues The Affordable Care Act (ACA) policies are intended to give patients more access to health care without any restrictions as in the past that were imposed by the Health Care Industry and at a reasonable cost capping the administrative costs to the industry to no more than 20% of what the insurance costs. These restrictions were based on how much a person paid for health insurance, the...
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...and cadmium, copper, nickel, and lead levels in rice paddies were above international standards * Heavy metals found in road dust – lead over 300 times that of a control village’s road dust and copper over 100 times The environmental impact of the processing of different electronic waste components: E-Waste Component | Process Used | Potential Environmental Hazard | Cathode ray tubes (used in TVs, computer monitors, ATM, video cameras, and more) | Breaking and removal of yoke, then dumping | Lead, barium and other heavy metals leaching into the ground water and release of toxic phosphor | Printed circuit board (image behind table - a thin plate on which chips and other electronic components are placed) | De-soldering and removal of computer chips; open burning and acid baths to remove final metals after chips are removed. | Air emissions as well as discharge into rivers of glass dust, tin, lead, brominated dioxin, beryllium cadmium, and mercury |...
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...The Affordable Care Act and Medicaid Albany State University Healthcare in America is the most talked about topic today. This seems to be true since the Patient Protection and Affordable Care Act, commonly known as “Obamacare”, is in place. This act was signed into law back in 2010. It took four years for the changes to take place and now citizens of America are required to have a health insurance plan in 2014. Open enrollment for “Obamacare”, insurance plans ends March 31, 2014. Those who do not have insurance by then, will be taxed 1% of their salary by the IRS or receive a tax penalty of 95 dollars. The Affordable Care Act has made many changes to health insurance coverage, such as Medicare and Medicaid, family insurance plans and more. If one cannot afford health insurance, Medicaid will be extended under certain conditions. Medicaid will be extended to individuals or families who earn up to 133% of federal poverty level. According to About.com, federal poverty level for an individual is $15,281. For a family of four, the federal poverty level is $31,321.50. Individuals or families who earn too much for Medicaid will receive tax credits only if their income level is below 400% of poverty level. According to About.com, for an individual to qualify for a tax credit, their income would have to be $45,960. For a family of four, 94,200. The credit is then applied monthly instead of a yearly tax rebate. There are also reduced copayments and deductibles for these individuals...
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...Associate Level Material Appendix A: U.S Health Care Timeline Use the following timeline or create a timeline of your own with eight major events, including the four provided below, from the last 50 years. You may change the dates in the box to match the dates of your events. Include the following in your timeline: • Medicare and Medicaid • HIPPA of 1996 • State Children’s Health Insurance Program (SCHIP) • Prospective Payment System (PPS) |1960 |Prospective Payment System (PPS)- The mid-1960's brought about the view that access to| | |good quality health care could be provided for the U.S., regardless of ability to | | |pay. The PPS is a means to determine insurance payments for Medicaid plans. It is a | | |Medicare system that pays hospitals a set amount for covered diagnostic or treatment | | |services offered under Medicaid. | |1965 | | | | | | |Medicare and Medicaid- Medicaid is a federal program that provides insurance...
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...people are treated fairly when it comes to health insurance policies. On March 23, 2010 President Barack Obama signed the affordable care act into law (American Public Health Association, 2014). This law will potentially provide up to 44 million people the chance to be able to gain a health care plan that they can afford. Several people have a big issue with this because some regulations of the law give a large amount of control to the federal government. People argue that this involvement from the government makes the law unconstitutional. The biggest question being is if the pros outweigh the cons and if the plan will benefit the people of this nation There have always been issues in this country with healthcare being extremely expensive. This being the case, many people have been forced to go uninsured and put their own health at risk simply because they could not afford to make it a priority. Not only does this cause them to go without preventative care, but when the time comes in an emergency and medical attention is needed the average American cannot afford to pay the out of pocket medical bill and ends up filing bankruptcy on the medical bill resulting in the hospital losing a ridiculous amount of money. President Obama along with many Americans agreed that something has to be done to change this travesty. There are many pros and cons to the Affordable Care Act that needs to be evaluated in order to decide if this law is good or bad for our country. The following...
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...and Affordable Care Act is a United States federal statute that Barack Obama implemented during his first term of presidency. It was signed into law in 2010. This act is informally known as Obama Care, Obama’s Health Care Reform, The Affordable Care Act, or is abbreviated as PPACA. Although it has many different names, it is all the same thing; an attempt to improve the healthcare system of the United States. The main goal of The Patient Protection and Affordable Care Act is to make insurance services available to the 32 million Americans who currently do not have it, and to make it more affordable (a role in which the name assumes). Although it is uncertain right now what this will look like in the years to come, we will see how this is played out starting in 2014. Obama Care, prospectively, will have great effects on a range of age groups. The main focus of Obama’s healthcare reform is to make insurance available to those who previously could not access it; no matter the reason. If viewed chronologically, the first age group it will benefit are the children(mid-teens and younger). According to the White House, there are 17.6 million children with preexisting conditions. Previously, these children would be denied coverage from insurance companies based on said conditions. Obama’s reform changes that and makes it illegal to deny anyone healthcare based on preexisting health issues or risks of therefor. With Obama Care in effect, these children can get the care they need from the...
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...Health Care in 2015 I would like you to meet a patient from the year 2015. He lives in a world in which years ago America's leaders made tough but wise decisions. They built on the best aspects of American health care and unleashed the creative power of the competitively driven marketplace. These changes resulted in dramatic improvements to the U.S. health care system — lower costs, higher quality, greater efficiency, and better access to care. The patient, Rodney Rogers, is a 44-year-old man from the small town of Woodbury, Tennessee. He has several chronic illnesses, including diabetes, hypercholesterolemia, and hypertension. He is overweight. He quit smoking about eight years ago. His father died in his early 50s from a massive myocardial infarction. In 2005, Rodney chose a health savings account in combination with a high-deductible insurance policy for health coverage. Rodney selected his primary medical team from a variety of providers by comparing on-line their credentials, performance rankings, and pricing. Because of the widespread availability and use of reliable information, which has generated increased provider-level competition, the cost of health care has stabilized and in some cases has actually fallen, whereas quality and efficiency have risen.1,2 Rodney periodically accesses his multidisciplinary primary medical team using e-mail, video conferencing, and home blood monitoring. He owns his privacy-protected, electronic medical record. He also chose to...
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...Unit 36, P4 Legal aspects and physical resources As my business is starting up there are several legal statuses that I can have which are; Legal Aspects; * My legal status: Sole trader * Legal liability: Unlimited liability * Trading terms and conditions: Being owner of the business this means that I can do as I wish and go against the terms and conditions which I have set for my business, for example of a term would be the closure of the shop at 9pm A sole trader owned company is a business which is owned just by one person. There are several disadvantages and advantages when being a sole trader. Being a sole trader will mean that a lot of the businesses work will be on one person’s shoulders. This means there will be a lot of pressure and stress on the single person. Having privacy within a company is highly important, being a sole trader means that you have full control of the business and its financial incomes, this means that other companies don’t have access to your information. Also there are fewer legal restrictions so this will allow the business to be more flexible. However, hours are generally longer and working alone may mean that they will need more acquired skills for their business. Also there is no obligation when it comes to sharing profits. I have chosen to be a sole trader because as my business is small I feel like it would cause less complications then if I was to start as a partnership. Partnership A Partnership is where a business...
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