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Unless otherwise identified, this term includes an Exchange serving the individual market for qualified individuals and a SHOP [Small Business Health Options Program] serving the small group market for qualified employers, regardless of whether the Exchange is established and operated by a State (including a regional Exchange or subsidiary ...
The private health insurance industry fears that restricted eligibility and a market size that is too small could result in higher premiums, encourage "cherry-picking" of customers by insurers, and force a clearance of the exchange. That is what some believe will happen in Texas and California in their failed exchanges. [99]
There is a lack of empirical evidence to describe the impact of conflict of interest in the health care industry. [1] Business interests influence the direction of cancer research and the adoption of new practices in therapy. [2] University projects which receive industry funding are more likely to produce research outcomes which favor their ...
Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare (United States) or equivalent State programs. The manner in which this is done varies, and persons engaging ...
The move comes after the company repeatedly missed earnings targets, setting off unrest among shareholders that spilled into public view in recent weeks.
"Medicaid serves a key role in the health insurance market, and for many people, there is no alternative," Eric Seiber, Ph.D., a professor in the College of Public Health and director of the ...
Consider a potential case of moral hazard in the health care market caused by the purchase of health insurance. Assume health care has constant marginal cost of $10 per unit and the individual's demand is given by Q = 20 − P. Assuming a perfectly competitive market, at equilibrium, the price will be $10 per unit and the individual will ...
Insurance regulatory law is the body of statutory law, administrative regulations and jurisprudence that governs and regulates the insurance industry and those engaged in the business of insurance. Insurance regulatory law is primarily enforced through regulations, rules and directives by state insurance departments as authorized and directed ...