Medicare and Medicaid programs; requirements for physician incentive plans in prepaid health care organizations--HCFA. Final rule.
This final rule amends the regulations established by a March 27, 1996, final rule with comment period. The regulations govern physician incentive plans operated by Federally-qualified health maintenance organizations and competitive medical plans contracting with the Medicare program, and certain health maintenance organizations and health insuring organizations contracting with the Medicaid program. As explained in the March 27 rule, the provisions of this final rule will also have an effect on certain entities subject to the physician referral rules in section 1877 of the Social Security Act.
D002204:Capitation Fee; D014487:Centers for Medicare and Medicaid Services, U.S.; D004465:Economic Competition; D006279:Health Maintenance Organizations / Q000191:economics / Q000331:legislation & jurisprudence; D008484:Medicaid / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000331:legislation & jurisprudence*; D010816:Physician Incentive Plans / Q000191:economics / Q000331:legislation & jurisprudence*; D017061:Prepaid Health Plans / Q000191:economics / Q000331:legislation & jurisprudence*; D011640:Public Policy; D014481:United States