Overview of Medicare Program: Hearing Before the Subcommittee on Medicare and Long-Term Care of the Committee on Finance, United States Senate, One Hundred First Congress, First Session, March 3, 1989, Volume 4U.S. Government Printing Office, 1989 - 197 pages |
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annual average benefits bills Chairman changes charges coinsurance committee congestive heart failure Congress coverage covered deductible deficit diagnosis disabled doctors Effectiveness Initiative elderly enrolled enrollees ETHEREDGE Financing Administration fiscal going Government growth HCFA Health Care Financing health care system health insurance health services high Medicare hospitals hip fracture home health hospital payment hospital services immunosuppressive drugs income increase inpatient hospital Institute of Medicine issues Karen Davis legislation limit Lohr long-term long-term care major malpractice market basket MCCA Medi Medicaid Medicare beneficiaries Medicare program Medicare's million nursing occupational therapy out-of-pocket outlays outpatient overall patients percent physician payment physician services precerebral arteries premiums prescription drug problems Prospective Payment providers quality assurance reduce rural areas rural hospitals Senator ROCKEFELLER social security Subcommittee surgery surgical taxes transient ischemic attack trust funds update factors urban
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Page 118 - Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided...
Page 48 - Notwithstanding any other provision of this title, no payment may be made under part A or part B for any expenses incurred for items or services — (1) which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member...
Page 118 - ... shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person...
Page 181 - The patient with a long history of multiple sclerosis is experiencing increased difficulty with coordination due to spasticity and is no longer able to feed herself. She needs an occupational therapist to decide whether adaptive equipment would allow her to regain independence. Only the occupational therapist is skilled in assessing and providing this type of equipment, and no other service 'is necessary. In all of these instances occupational therapy would be provided in accord with existing Medicare...
Page 58 - US Congress, House Committee on Ways and Means, Background Material and Data on Programs within the Jurisdiction of the Committee on Ways and Means, March 3, 1986, p.
Page 136 - ... care; (E) evaluate the current research on methodologies for measuring quality of care, and suggest areas of research needed for further progress; (F) evaluate the adequacy and range of methods available to correct or prevent identified problems with quality of care; (G) review mechanisms available for promoting, coordinating, and supervising at the national level quality review and assurance activities...
Page 136 - ... (D) evaluate the adequacy and focus of the current methods for measuring, reviewing, and assuring quality of care; (E) evaluate the current research on methodologies for measuring quality of care, and suggest areas of research needed for further progress; (F) evaluate the adequacy and range of methods available to correct or prevent identified problems with quality of care; (G) review mechanisms available for...
Page 181 - These manuals require that occuaptional therapy be prescribed by a physician, be performed by a qualified occupational therapist or assistant, and be reasonable and necessary for the treatment of the individual's illness or injury. Occupational therapy is considered reasonable and necessary when "an expectation exists that the therapy will result in a significant practical improvement in the individual's level of functioning within a reasonable period of time (Ch.
Page 179 - ... health benefit only if they are in need of another service. Requiring a multitude of services when a person needs only one is neither logical nor cost effective, and we urge the Subcommittee to consider legislative modifications that would establish occupational therapy as the fourth qualifying service under the Medicare home health benefit. Occupational therapy is an important part of the home health care provided to many Medicare beneficiaries. It is especially necessary for individuals who...
Page 45 - Medicare include the following: — part time or intermittent nursing care provided by, or under the supervision of, a registered professional nurse; — physical, occupational, or speech therapy; — medical social services provided under the direction of a physician; — medical supplies and equipment (other than drugs and medicines); — medical services provided by an intern or resident enrolled in a teaching program in a hospital affiliated...