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The 42-bed hospital has been in the works since 2020, with a tentative opening in 2026, if not for the existing providers' objection to the new facility's construction. In 2018, the Department of Health and Human Services recommended that states repeal their CON laws because they are a significant reason for increasing medical costs, and they ...
Physician's News Digest article on Certificates of Medical Necessity; Statutory definition of a CMN at the SSA website; Medicare manual that provides exhaustive information about the practical use of CMNs, particularly section 5.3. This is the official source of information for contractors administering the Medicare system about the use of CMNs.
Medicare pays for medical items and services that are "reasonable and necessary" or "appropriate" for a variety of purposes. [1] By statute, Medicare may pay only for items and services that are "reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member" unless there is another statutory authorization for payment.
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 ...
An increased number of beds may be due to patient preference for in-patient (rather than outpatient) care in a region." [ 5 ] [ self-published source ] Enoch Powell , the British Minister of Health, propounded a similar proposition, which he called Parkinson's law of hospital beds: "the number of patients always tends to equality with the ...
Medical certificates are sometimes required to obtain certain health benefits from an employer, to make an insurance claim, for tax purposes, or for certain legal procedures. Medical certificates are used to indicate eligibility of activity, such as the use of disabled parking. Medical certificates can also be used to describe a medical ...
Trump was initially treated by medical staff at Butler Memorial Hospital. According to Jackson, doctors “provided a thorough evaluation for additional injuries that included a CT of his head ...
Fee-for-service is a traditional kind of health care policy: insurance companies pay medical staff fees for each service provided to an insured patient. Such plans offer a wide choice of doctors and hospitals. Fee-for-service coverage falls into Basic and Major Medical Protection categories.