TOPIC: Financing Health Care: Insurance, Managed Care, Medicaid, and Other Programs

Materials

• Quality Health Care for Children with Special Health Care Needs Quality-pdf
  • A one page handout for families, providers, and professionals that defines key elements of quality health care for children with special health care needs, based on 6 Family Voices principles.
• 1905(a) Services 1905(a)-pdf
  • List of services specified by the 1905(a) section of the Social Security Act for inclusion under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT), Medicaid's comprehensive and preventive child health program.
• Basic Private Health Insurance Private Insurance-pdf
  • Description of Group and Individual Insurance, HMO, PPO, and POS plans, and Patient Bill of Rights.
• Developmental Disabilities Act / Family Support DDA-pdf
  • Discussion of the DD Act, providing funding for Developmental Disabilities Planning Councils in each state to assist people with developmental disabilities to live in the least restrictive environment and to actively participate in their communities by emphasizing family support services.
• ERISA ERISA-pdf
  • Information about the Employee Retirement Income Security Act of 1974 (ERISA), legislation that regulates the administration of employee pension and benefit plans.
• IDEAIDEA-pdf
  • Discussion of the Individuals with Disabilities Education Act (IDEA), which provides for a free, appropriate, public education (FAPE) to children with disabilities aged 3 to 21. Covers eligibility and discussion of related services.
• Medicaid WaiversWaivers-pdf
  • Discussion of Medicaid Waivers, including the Katie Beckett Waivers, which are state-run programs that permit states to use flexibility to design publicly financed health care systems outside of certain federal Medicaid statutory and regulatory requirements.
• Private Insurance: Managed Care Issues & Advocacy Managed Care-pdf
  • Discussion of the issues involved with managed care programs and a brief guide for parents on how to advocate within your health plan for services for your child with special needs.
• Private Insurance Checklist Checklist-pdf
  • Checklist of programs, services, and equipment for determination of insurance coverage.
• Public Health Payment SystemsPayment Systems-pdf
  • Description of programs financed by the Public Health Systems, including Medicaid, Early Periodic Screening, Diagnosis and Treatment (EPSDT), Temporary Assistance to Needy Families (TANF), Social Services Block Grant (SSBG), Foster Care and Adoption Assistance, Supplemental Security Income (SSI), 1915(b) & (c) Waivers, Tax Equity and Fiscal Responsibility Act (TEFRA), 1115 Waivers, and State Supplemental Assistance Programs.
• Rehabilitation Act of 1973Rehab Act-pdf
  • Description of legislation which funds vocational rehabilitation, employment and independent living programs in the states.
• SCHIPSCHIP-pdf
  • Description of State Children's Health Insurance Program (SCHIP)
• Strategies for Improving Health Care Financing SystemsStrategies-pdf
  • The legislative process is discussed to provide a background for improving health care financing systems.
• Ticket to Work ProgramTicket to Work-pdf
  • Description of the Ticket to Work program, which provides support for persons between the ages of 18 and 64 with disabilities who receive Supplemental Security Income (SSI) or Social Security Disability Income (SSDI) as they move into employment.
• Title V of the Social Security Act Title V-pdf
  • Description of Title V which provides for public health programs, including programs administered by the Maternal and Child Health Bureau (MCHB).