Defining and determining medical necessity in Medicaid Managed Care

MarkusA.R.; WestK.D.

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Defining and determining medical necessity in Medicaid Managed Care

机译：定义和确定医疗补助管理式医疗中的医疗必要性

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OBJECTIVES: In 2013, the American Academy of Pediatrics published a policy statement calling for pediatricians to be informed about the need for specific pediatric medical necessity language because children deserve "the intent embedded in Medicaid." This study aims to explore the definitions and determinations of medical necessity in Medicaid Managed Care (MMC), document the relevant language used throughout Medicaid, and investigate whether the federal standard of medical necessity for children is replicated in related state documents.

机译：目标：2013年，美国儿科学会发布了一项政策声明，呼吁儿科医生了解特定的儿科医疗必需语言的必要性，因为儿童应得到“嵌入在医疗补助中的意图”。这项研究旨在探讨医疗补助医疗管理（MMC）中医疗必要性的定义和确定，记录整个医疗补助中使用的相关语言，并调查是否在相关的国家文件中复制了联邦儿童医疗必需标准。

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《Pediatrics: Official Publication of the American Academy of Pediatrics》 |2014年第3期|共7页
作者
MarkusA.R.; WestK.D.;
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原文格式 PDF
正文语种 eng
中图分类儿科学;
关键词
Child health; Medicaid; Medical necessity; Pediatrician;

机译：儿童健康;医疗补助;医疗必需品;儿科医生;

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1. Defining and determining medical necessity in Medicaid Managed Care [J] . MarkusA.R., WestK.D. Pediatrics: Official Publication of the American Academy of Pediatrics . 2014,第3期

机译：定义和确定医疗补助管理式医疗中的医疗必要性
2. Can Medicaid managed care provide continuity of care to new Medicaid enrollees? An analysis of tenure on Medicaid (see comments) [J] . Carrasquillo O, Himmelstein DU, Woolhandler S, American journal of public health . 1998,第3期

机译：医疗补助管理式护理能否为新的医疗补助参加者提供连续的护理？对医疗补助权的使用权分析（请参阅评论）
3. Defining Medical Necessity under the Patient Protection and Affordable Care Act [J] . Daniel Skinner Public administration review . 2013,第sepaspeca期

机译：根据《患者保护和负担得起的医疗法案》定义医疗必要性
4. An intelligent medical Replenishment System for managing the medical resources in the healthcare industry [C] . Valerie Tang, Stephen W.Y. Cheng, K.L. Choy, IEEE International Conference on Fuzzy Systems . 2016

机译：用于管理医疗行业医疗资源的智能医疗补给系统
5. The future of Kentucky Medicaid: A study of the proposed partnership between maternal child health centers, managed care Medicaid and state medical schools [D] . Bobbitt, Jennifer Lynne 1998

机译：肯塔基州医疗补助的未来：对孕产妇儿童保健中心，管理式医疗补助和州立医学院之间的拟议合作关系的研究
6. Can Medicaid managed care provide continuity of care to new Medicaid enrollees? An analysis of tenure on Medicaid. [O] . O Carrasquillo, D U Himmelstein, S Woolhandler, 1998

机译：医疗补助管理式护理能否为新的医疗补助参加者提供护理的连续性？对医疗补助制度的任期分析。
7. Evaluation of Iowa’s Medicaid Managed Care Program. Results of the 2007 Survey of Iowa Medicaid Managed Care Enrollees. Final Report to the Iowa Department of Human Services [O] . Jean C. Willard, Elizabeth T. Momany, Peter C. Damiano, 2008

机译：IOWA的医疗补助管理计划评估。 2007年IOWA Medicaid Care Care Renllees的结果。对爱荷华州人类服务部的最后一份报告
8. Benchmarking Medicare Managed Care Plan Enrollment Estimates from the Medical Expenditure Panel Survey and Administrative Enrollment Files from the Centers for Medicare & Medicaid [R] . Sing, M. 2008

机译：医疗保险和医疗补助中心医疗支出小组调查和行政登记档案的医疗保险管理护理计划入学评估基准

Defining and determining medical necessity in Medicaid Managed Care

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