Health Maintenance Organization


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Health Maintenance Organization

Commonly called an HMO. A nonprofit organization that offers health insurance to a group of persons and charges members of the group the same monthly premium. Most HMOs require policyholders to have a primary physician who provides referrals for specialists and other medical services. Without these referrals, medical care generally will not be covered. This fact has made HMOs somewhat controversial. However, they generally operate at a lower out-of-pocket cost to consumers. They trace their origins to the early 20th century, but became more popular after the Health Maintenance Organization Act of 1973.
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At least six states have outlawed gag rules under which some health maintenance organizations threaten to dismiss doctors if they inform patients about alternative care that might add to costs.
LEGISLATORS SCRUTINIZE HMO CARE
In 1992, Antelope Valley Hospital paid Lancaster Community Hospital $250,000 to drop a 5-year-old antitrust lawsuit alleging AVH engaged in unfair competition by requiring health maintenance organizations and insurance companies to use AVH for all members if any wanted obstetrics services.
HOSPITAL OB WARD ON HOLD; SAFETY BILL FORCES WAIT OB WARD OPENING AT HOSPITAL DELAYED
Qualified (q) Rating Modifiers may be assigned to Health Maintenance Organizations (HMOs), Canadian insurers and UK insurers that meet the minimum size and operating experience requirements for a Best's Rating but do not subscribe to our interactive rating process.
Best's Rating Changes
As increasing numbers of health maintenance organizations look at cost-cutting measures to put their companies back in the black, many are considering or implementing premium hikes.
A Double Dose
It includes 329 health maintenance organizations and other managed care plans, which voluntarily supplied information on more than 50 measures.
HMO CARE LEVELS DIFFERENT AROUND U.S., STUDY SHOWS; PANEL SAYS LIVES COULD BE SAVED
Frank Keating, a Republican, has signed into law a bill that allows patients to sue their health maintenance organizations for punitive damages.
New Oklahoma Law Puts HMOs on Defensive
Qualified Ratings assigned to Health Maintenance Organizations (HMOs), Canadian insurers and U.
Best's Rating Changes
Advocates for children, the elderly and the disabled worry that states will cut services, reduce coverage of fast-growing benefits like prescription drugs or use cheap, low-quality nursing homes and health maintenance organizations.
GOVERNORS RESIST MEDICAID PLAN : BIPARTISAN GROUP FEARS CLINTON PROPOSAL WILL SHIFT COST TO STATES
The American Association of Health Plans, the leading trade group for health maintenance organizations and other managed care plans, said its members ``do not and should not require outpatient care for removal of a breast.
HEALTH PLANS OK HOSPITAL STAY FOR MASTECTOMIES

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