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A hospital or provider organization desiring to set up its own health plan will often outsource certain responsibilities to a third-party administrator. For example, an employer may choose to help finance the health care costs of its employees by contracting with a TPA to administer many aspects of a self-funded health care plan.
Pharmacy benefit management. In the United States, a pharmacy benefit manager ( PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.
Self-funded health care, also known as Administrative Services Only ( ASO ), is a self insurance arrangement in the United States whereby an employer provides health or disability benefits to employees using the company's own funds. [1] This is different from fully insured plans where the employer contracts an insurance company to cover the ...
The Centers for Medicare & Medicaid Services ( CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
The Occupational Safety and Health Administration ( OSHA; / ˈoʊʃə /) is a regulatory agency of the United States Department of Labor that originally had federal visitorial powers to inspect and examine workplaces. [2] : 12, 16 The United States Congress established the agency under the Occupational Safety and Health Act (OSH Act), which ...
t. e. The Clinton health care plan of 1993 was a healthcare reform package proposed by the administration of President Bill Clinton and closely associated with the chair of the task force devising the plan, First Lady of the United States Hillary Clinton . President Clinton had campaigned heavily on health care in the 1992 presidential election.
e. In the United States, a health maintenance organization ( HMO) is a medical insurance group that provides health services for a fixed annual fee. [1] It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care ...
t. e. The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving ...