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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
It had 3.7 million medical members, 1.5 million Medicare Part D members, and 900,000 Medicaid members. [2] In May 2013, the company was acquired by Aetna for $5.7 billion. History
Aetna offers three different Medicare Part D plans, with offerings available across the United States. Find out what these plans cover and how much they may cost.
Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
Individuals affected by the Medicare Part D coverage gap will receive a $250 rebate, and 50% of the gap will be eliminated in 2011. [36] The gap will be eliminated by 2020. Insurers' abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014. [4] Insurers are prohibited from dropping policyholders when they ...
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