Standards through state and federal oversight

Assignment Help HR Management
Reference no: EM13738054 , Length: 1000 Words

Medicare is a federally regulated program that mandates compliance to its standards through state and federal oversight. One of the primary purposes of Medicare regulations is the protection of its recipients. Medicare Advantage is part of the Medicare Modernization Act, which was passed in 2003. Search the Internet by using the following keywords:

  • Medicare regulations
  • Centers for Medicare
  • Medicaid services

On the basis of your research, answer the following questions:

  • What are the purposes of Medicare regulations other than the one mentioned above?
  • How will the federal government enforce compliance in the Medicare Advantage program? Which two other Medicare regulations do you think are the most important for managed care organizations and why?
  • Do you think Medicare and Medicaid programs face challenges from the perspectives of providers, the government, and consumers (recipients of Medicare or Medicaid)? Why or why not?
  • What are the different services provided by the Medicare and Medicaid programs? Do you feel there is a need to have two different programs? Why or why not?
  • Discuss the advantages and disadvantages of Medicare programs such as Medicare Advantage and Medicare Part D. Do you think Medicare Advantage programs ensure the survivability of Medicare? Why or why not?

Additionally, respond to the questions given below after reading the following information in regard to control of managed care organizations at the state level.

States have a broad range of control of managed health care organizations. The main interests of the states are to protect the interest of the consumer and regulate the structure of MCOs.

  • Discuss the regulatory structure used to regulate MCOs and health insurers at the state level.
  • Discuss how states came to be the primary regulators of insurance.
  • Evaluate the most critical components of state oversight of HMO operations.
  • Review the licensing requirements for MCOs in your state and describe the specific requirements to obtain a Certificate of Authority (COA). Compare to the requirements discussed in the course textbook.
  • What are the protections available to consumers under the law in your state? Compare these protections to what is discussed in the textbook.
  • In your opinion, are the state regulations designed for the consumers, or are they designed for the MCOs? Use your course and text readings to support your answer.

Reference no: EM13738054

Questions Cloud

Describe the role of cosmic occurrences or natural phenomena : Include the role of cosmic occurrences or natural phenomena, such as celestial bodies, floods, rain, wind, and fire. Compare the creators, creations, the steps or cycle of creation
Determine which is the correct main claim : Read the following thesis statement and determine which is the correct main claim: Regular exercise is good not only for the body but for the mind as well. Studies have shown that when we exercise a molecule called irisin is produced in the brain. Th..
Best introduce a counter-claim to a counter-argument : Which of the following words would best introduce a counter-claim to a counter-argument?a apparentlyb howeverc additionallyd supposedly
Valuing diversity is commonly regarded as a virtue : Valuing diversity is commonly regarded as a virtue in today's business world. Why is diversity important to value? What are some strategies we can use to reflect the value of diversity in our written work?
Standards through state and federal oversight : Medicare is a federally regulated program that mandates compliance to its standards through state and federal oversight. One of the primary purposes of Medicare regulations is the protection of its recipients. Medicare Advantage is part of the Med..
Important features of effective communication : What do you consider to be the most important features of effective communication? Explain your choices.
Managerial decision making : Take a position on whether or not managerial groups within a large organization are more likely to make better decisions than individual managers within the same organization. Provide support for your position.
Risks of not considering the audience needs : You are preparing to write a formal report to be presented to management at your workplace. What are some potential needs for this audience you should be aware of when writing the report? What are the risks of not considering the audience's needs?
Design an active first order low pass filter which passes f : Use a capacitor, a resistor and an operational amplifier circuit to design an active first order low pass filter which passes frequencies that human can hear (below 15kHz). Show all the calculations required to find the values of all the passive comp..

Reviews

Write a Review

HR Management Questions & Answers

  Improve problem solving capabilities within organization

Types of teams as to their effectiveness that will improve problem solving capabilities within organizations.

  Influence tactics help in reducing organizations politics

Explain the different types of influence tactics that will be of a help “if adopted” in reducing the organizational politics.

  Report on citigroup''s hr service level agreement

Human Resources or Human Resource Management deals with HR Service Level Agreement. HR Service Level Agreement is an agreement made between the employer and the employee, which states that the employee would work under any client and sometimes any ti..

  A project report on hrm

Human Resource Management as the name suggests, it is a management discipline which deals with the human i.e. the workforce aspect of organizations. Need and practices of HRM are inevitable in present scenario of extreme competition where "Talent War..

  Hrp: recruitment and selection

Recruitment and Selection is the initial ladder of any Human Resource Planning process and contains an immense significance for any organisation.

  A project report on study of statutory complainces

Statutory compliance and its immense knowledge are crucial to be understood in an organization. It contains all the forms, procedures and acts applicable in a company.

  Operant conditioning and Reinforcement

Operant conditioning is a learning process where behaviour is controlled by its consequences. In this process an individual's behaviour can be modified through the use of positive or negative reinforcement.

  Effectiveness of training programs in achieving customers an

The main motive for conducting this research is to provide broad range of research of the literature and their reviews related to training and development and assisting the employees in providing customers satisfaction.

  A critical analysis of hr processes and practices in fedex c

FedEx is illustrious for its novel HR processes and practices that have greatly accounted for its success.

  Integrating culture and diversity in decision making

People in the organization are known as Google where they share common goals and have common vision.

  Impact of employee attrition on people management in organis

Talent management implies recognizing a person's inherent skills, traits, personality and offering him a matching job.

  Labour dissonance at maruti suzuki india limited: a case stu

This Case Study focuses on various issues related to Labour Unrest at Maruti Suzuki India Limited.

Free Assignment Quote

Assured A++ Grade

Get guaranteed satisfaction & time on delivery in every assignment order you paid with us! We ensure premium quality solution document along with free turntin report!

All rights reserved! Copyrights ©2019-2020 ExpertsMind IT Educational Pvt Ltd