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  1. Medicare coverage for oncology services.

    Article, Communication - En anglais

    American Cancer Society National Conference on Purchasing Oncology Services : Current Methods and Models in the Marketplace. Chicago, IL, USA, 1997/09/11.

    Medicare's mission is to assure health care security for our beneficiaries.

    Title XVIII of the Social Security Act (the Act) provides the Health Care Financing Administration (HCFA) with the authority to fulfill this mission.

    Although Medicare is considered a defined benefit program, the Act vested Medicare with the discretionary authority to make specific policy decisions when necessary.

    HCFA's discretionary authority, which is found at1862 (a) (1) (A) of the Act, enables HCFA to provide coverage for services that are reasonable and necessary for the treatment and diagnosis of illness or injury or to improve the functioning of a malformed body member.

    To determine whether a service is reasonable and necessary, HCFA relies on authoritative evidence.

    This evidence includes, but is not limited to, approvals from appropriate federal agencies, such as the Food and Drug Administration, and systematic evaluations of scientific literature via technology assessments.

    HCFA also may decide that a service warrants a unique type of coverage policy, which is referred to as coverage with conditions.

    This form of coverage is a middle ground between strict noncoverage and general coverage for a medical service that appears promising, but still is evolving.

    All these policy specifications effect Medicare coverage of oncology services. (...)

    Mots-clés Pascal : Cancérologie, Service hospitalier, Spécialité médicale, Financement, Politique sanitaire, Vieillard, Homme, Programme sanitaire, Article synthèse, Système santé, Etats Unis, Amérique du Nord, Amérique, Medicare

    Mots-clés Pascal anglais : Cancerology, Hospital ward, Medical specialty, Financing, Health policy, Elderly, Human, Sanitary program, Review, Health system, United States, North America, America

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0296480

    Code Inist : 002B30A01B. Création : 27/11/1998.