EMTALA: Dedicating an emergency department near you

This article offers a brief history of healthcare civil rights, describes a range of healthcare issues that have a civil rights component, and discusses the need for an expanded civil rights framework to guide the provision of health care. Unequal health care based on race and ethnicity has received renewed attention over the past several years, but healthcare discrimination based on socioeconomic status, disability, age, and gender also deserve careful attention

A Crosswalk Between the Final HIPAA Privacy Rule and Existing Federal Substance Abuse Confidentiality Requirements

This Issue Brief provides an overview of and crosswalk between the Privacy Rule and the federal Confidentiality of Alcohol and Drug Abuse Patient Records statute, 42 U.S.C. § 290dd-2, and its implementing regulations at 42 C.F.R. Part 2 ( 42 C.F.R. Part 2 ). The crosswalk is intended to highlight the differences between the requirements of the Privacy Rule and 42 C.F.R. Part 2. In addition, this Issue Brief addresses the Privacy Rule\u27s applicability to special populations and psychotherapy services provided by substance abuse paraprofessionals

Care Coordination and Physical and Behavioral Service Integration in Managed Care Contracts: Analysis and Sample Purchasing Specifications

This double Issue Brief on the issue of managed care contracts and care coordination has been prepared for the Substance Abuse and Mental Health Services Administration as part of a series that examines legal issues in managed care for persons with mental illness and addiction disorders. This Issue Brief is presented in two parts. Part 1 presents an analysis, based on managed care contract data bases developed by CHSRP, of the extent to which public and private group purchasers maintain agreements that specify care coordination as part of the standard of care for persons with co-occurring physical and/or behavioral illnesses and conditions. Part 2 sets forth sample purchasing specifications that are designed to establish care coordination as part of the standard of care

The Ticket to Work and Work Incentives Improvement Act of 1999: Implications for the Design and Support of Comprehensive Integrated Health Systems for Persons with Mental Illness and Addiction Disorder Disabilities

This report is designed to provide an overview of the Medicaid provisions of the Ticket to Work and Work Incentives Improvement Act of 1999, Public Law 106-170. This report considers the implications of the Act for the design and support of comprehensive, Medicaid-financed systems of health care for workers with severe disabilities and impairments, with a specific focus on persons with mental illness and addiction disorder disabilities. The Act, described by advocates for persons with disabilities as the most important piece of disability-related legislation since the enactment of the Americans with Disabilities Act of 1990, expands the availability of health care and employment preparation and support services for working-age adults with disabilitie

Public Health Communicable Disease Reporting Laws: Managed Care Organizations\u27 Laboratory Contracting Practices and Their Implications for State Surveillance and Reporting Statutes

This report, prepared for the U.S. Centers for Disease Control and Prevention by the GWU Center for Health Services Research & Policy (CHSRP), presents findings from analyses of contractual specifications related to public sector managed care contractors\u27 duties and activities related to public health surveillance and education activities for communicable disease control, specifically HIV/AIDS, sexually transmitted diseases, and tuberculosis

Model Managed Care Contract for Health Professionals and Clinical Providers of Mental Illness and Addiction Disorder Treatment and Prevention Services

The contracting process is one that health care professionals oftentimes find complex and confusing. Furthermore, studies of managed care service contracts between managed care organizations and health professionals who furnish mental illness and addiction disorder prevention and treatment services have found that these contracts often heavily favor the managed care organization by allowing the MCO broad latitude over a network professional\u27s service responsibilities, the rate of payment for covered benefits and extensive discretion over treatment decision-making. As an aid to its members, the American Medical Association (AMA) has drafted a model provider agreement that gives physicians in both individual and group practice a tool that can be utilized in the managed care contracting process. The AMA\u27s contract is designed to help physicians understand and negotiate the contracts they sign. At the same time, the model contract is designed as a general medical services template. As a result, specialty providers such as mental health and addiction disorder treatment professionals and clinical providers may find that the model does not address certain critical contracting issues which exist as a function of their specialty practices. In order to address the need for a customized model contract designed for use by health professionals and clinics furnishing mental health and addiction disorder treatment and prevention services, the Substance Abuse and Mental Health Services Administration (SAMHSA), funded the George Washington University Center for Health Services Research and Policy (CHSRP) to adapt the AMA model contract for use in this specialty area. Working in collaboration with a number of professional organizations including the National Association of Social Workers, the American Psychological Association, the National Association of Alcohol & Drug Abuse Counselors, the American Psychiatric Association, and the University of Maryland\u27s Department of Behavioral and Community Health — CHSRP has adapted the AMA contract for use in the area of mental illness and addiction disorder network agreements

Analysis of CareFirst\u27s Performance as a Charitable Not-for-Profit Health Insurance Company in the National Capital Area

The George Washington University School of Public Health and Health Services ( GWU ) and the Georgetown University Institute for Health Care Research and Policy ( GU )conducted this analysis on behalf of the DC Appleseed Center for Law and Justice in order to examine whether, in its operations and business practices, CareFirst BlueCross BlueShield ( CareFirst ) appears to be fulfilling its chartered mission for the National Capital Area. The study began as an analysis of the coverage and access implications for the region of a proposal made by CareFirst and WellPoint Health Networks, Inc. ( WellPoint ) to convert CareFirst to for-profit status and permit its acquisition by WellPoint for a price of $1.3 billion. Maryland\u27s Commissioner of Insurance rejected the proposal in March 2003. Upon the request of CareFirst and WellPoint, the insurance commissioners in the District of Columbia and Delaware suspended their review of the transaction