Book contents
- Frontmatter
- Contents
- List of Tables
- List of Figures
- Preface
- 1 LAWS, BUREAUCRATIC AUTONOMY, AND THE COMPARATIVE STUDY OF DELEGATION
- 2 RATIONAL DELEGATION OR HELPLESS ABDICATION? THE RELATIONSHIP BETWEEN BUREAUCRATS AND POLITICIANS
- 3 STATUTES AS BLUEPRINTS FOR POLICYMAKING
- 4 A COMPARATIVE THEORY OF LEGISLATION, DISCRETION, AND THE POLICYMAKING PROCESS
- 5 LEGISLATION, AGENCY POLICYMAKING, AND MEDICAID IN MICHIGAN
- 6 THE DESIGN OF LAWS ACROSS SEPARATION OF POWERS SYSTEMS
- 7 THE DESIGN OF LAWS ACROSS PARLIAMENTARY SYSTEMS
- 8 LAWS, INSTITUTIONS, AND POLICYMAKING PROCESSES
- APPENDIX A MMC LAWS USED IN CHAPTER 3
- APPENDIX B POLICY CATEGORIES USED FOR MMC LAWS IN CHAPTER 3
- APPENDIX C PROCEDURAL CATEGORIES USED FOR MMC LAWS IN CHAPTER 3
- APPENDIX D THE FORMAL MODEL OF DISCRETION
- References
- Author Index
- Subject Index
- Titles in the series
APPENDIX B - POLICY CATEGORIES USED FOR MMC LAWS IN CHAPTER 3
Published online by Cambridge University Press: 05 June 2012
- Frontmatter
- Contents
- List of Tables
- List of Figures
- Preface
- 1 LAWS, BUREAUCRATIC AUTONOMY, AND THE COMPARATIVE STUDY OF DELEGATION
- 2 RATIONAL DELEGATION OR HELPLESS ABDICATION? THE RELATIONSHIP BETWEEN BUREAUCRATS AND POLITICIANS
- 3 STATUTES AS BLUEPRINTS FOR POLICYMAKING
- 4 A COMPARATIVE THEORY OF LEGISLATION, DISCRETION, AND THE POLICYMAKING PROCESS
- 5 LEGISLATION, AGENCY POLICYMAKING, AND MEDICAID IN MICHIGAN
- 6 THE DESIGN OF LAWS ACROSS SEPARATION OF POWERS SYSTEMS
- 7 THE DESIGN OF LAWS ACROSS PARLIAMENTARY SYSTEMS
- 8 LAWS, INSTITUTIONS, AND POLICYMAKING PROCESSES
- APPENDIX A MMC LAWS USED IN CHAPTER 3
- APPENDIX B POLICY CATEGORIES USED FOR MMC LAWS IN CHAPTER 3
- APPENDIX C PROCEDURAL CATEGORIES USED FOR MMC LAWS IN CHAPTER 3
- APPENDIX D THE FORMAL MODEL OF DISCRETION
- References
- Author Index
- Subject Index
- Titles in the series
Summary
Listed here are additional examples of policy instructions written into MMC legislation.
General Policy Language
Washington, 1993 – SB5304: The legislature establishes the rationale for the MMC program.
BASIC HEALTH PLAN – FINDINGS. (1) The legislature finds that:
(a) A significant percentage of the population of this state does not have reasonably available insurance or other coverage of the costs of necessary basic health care services;
(b) This lack of basic health care coverage is detrimental to the health of the individuals lacking coverage and to the public welfare, and results in substantial expenditures for emergency and remedial health care, often at the expense of health care providers, health care facilities, and all purchasers of health care, including the state; and
(c) The use of managed health care systems has significant potential to reduce the growth of health care costs incurred by the people of this state generally, and by low-income pregnant women, and at-risk children and adolescents who need greater access to managed health care.
Provider Responsibilities and Rights
Florida's SB321 (1989): Provides a good example of how legislatures provide specific reporting requirements for participating HMOs:
6.4. Any HMO participating in the state group insurance program shall, upon the request of the department, submit to the department standardized data for the purpose of comparison of the appropriateness, quality, and efficiency of care provided by the HMO. Such standardized data shall include: membership profiles; inpatient and outpatient utilization by age and sex, type of service, provider type, and facility; and emergency care experience. […]
- Type
- Chapter
- Information
- Deliberate Discretion?The Institutional Foundations of Bureaucratic Autonomy, pp. 233 - 237Publisher: Cambridge University PressPrint publication year: 2002