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At least 163 records · Page 9Linked to original sources
PubMed2000

Effect of a state definition of an "emergency medical condition" legislation on medicaid managed care organization reimbursement.

STUDY OBJECTIVE: The state of Michigan passed Public Act 136 of 1997 requiring Medicaid managed care organizations (MMCOs) to pay for emergency services whenever presenting symptoms constituted an "emergency medical condition." The objective of this study was to evaluate MMCO reimbursement before and after enactment of this state law. METHODS: We conducted a retrospective comparison of reimbursement for lacerations needing repair (identified using Current Procedural Terminology codes from computerized billing data) for 2 time periods (before the state law was applicable [January through March 1998] and after the state law was applicable [April through June 1998]) from MMCO enrollees in 7 different MMCOs presenting to 4 urban emergency departments. Three months after billing submission was allowed for payment. Only refusal of reimbursement was evaluated. Data were analyzed using chi(2) and Fisher's exact test (values of P <.05 were considered significant). RESULTS: The total number of MMCO patients evaluated/total number of ED patients evaluated for the 2 periods was 1,769/32,646 and 3, 376/30,901, respectively (P <.05). The number of MMCO lacerations with no reimbursement/total number of MMCO lacerations for the 2 periods was 4/135 (3%) and 78/196 (40%), respectively (P <.001). CONCLUSION: Reimbursement by MMCOs for a procedure chosen to reflect a state-defined "emergency medical condition" is inadequate and significantly decreased during the 2 periods, with a significant increase in MMCO patients evaluated.

Chi-Square Distribution↗
PubMedDate not supplied

Characteristics of state legislation governing medical care at mass gatherings.

UNLABELLED: Organized mass gathering medical care (MGMC) has existed in the United States for 30 years, but there is little evidence to support any standard of care or uniformity in its delivery. OBJECTIVE: To determine whether MGMC regulations exist within state EMS legislation and to describe the characteristics of any such regulations. METHODS: The authors conducted a cross-sectional survey of U.S. state EMS directors in fall 1998 to determine the prevalence of formal legislation governing MGMC. The lead author received copies of legislation from every state EMS office that indicated such legislation existed. RESULTS: Responses were obtained from all 50 state EMS offices and that of the District of Columbia (n = 51). Only six (12%) states provide regulatory guidance for MGMC. These regulations reside within departments of health in all six states and within the divisions of EMS in three of these six. Only one state requires physician oversight of a medical action plan and minimum staffing by EMS personnel, respectively. No state addresses early defibrillation capability or EMS scope of practice. There is no agreement on the definition of either a mass gathering or minimum resource deployment. Public health and hygiene practices at mass gatherings also lack uniformity. CONCLUSION: Few states regulate MGMC. Existing regulations are poorly developed and lack both standardized terminology and content.

Cross-Sectional Studies↗
PubMedDate not supplied

Decontamination of medical devices: legislation and compliance to practice.

The amount of legislation and guidelines published on decontamination reflects the current attitude of politicians and the general public to the desire to reduce the risk of infection. Incidents, such as bovine spongiform encephalopathy (BSE) in cattle with the subsequent risk of transmission of variant Creutzfeldt-Jakob disease (VCJD), require greater compliance by healthcare workers to the guidance both in the hospital and the wider community. The change in care provision and the demands of government in training and education. This article will look at recent government guidance and the implications it has for clinical practice.

Decontamination↗