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14-Jul-2017 22:43

In contrast, an employer with a fully insured plan contracts with an insurance company and the insurance company administers and funds claims.Self-funded health plans are often utilized by large corporations and government entities.In the treatment of eosinophilic gastrointestinal disorders (EGIDs), amino-acid based elemental formulas are used for diagnostic and therapeutic purposes.These specialized formulas are considered to be “medical foods,” and when used in the treatment of EGIDs, are just as critical to the treatment plan of some patients as insulin is to a diabetic.In West Virginia, a predictable annual tradition occurs as the legislature wraps up its session: the state trauma providers receive an e-mail from the their state representatives and senators asking that we weigh in on whether to continue or repeal the state’s mandatory helmet law.As medical professionals, surgeons need to play a role in public policy decisions that relate to health care, including the debate over helmet laws.Medical foods are specially formulated and processed (as opposed to a naturally occurring foodstuff used in its natural state) for the partial or exclusive feeding of a patient by means of oral intake or enteral feeding by tube.Medical foods are intended for the dietary management of a patient who, because of therapeutic or chronic medical needs, has limited or impaired capacity to ingest, digest, absorb, or metabolize ordinary foodstuffs or certain nutrients, or who has other special medically determined nutrient requirements, the dietary management of which cannot be achieved by the modification of the normal diet alone.

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The law applies when an individual seeks treatment for a medical condition "or a request is made on the individual's behalf for examination or treatment for that medical condition." The U. government defines an emergency department as "a specially equipped and staffed area of the hospital used a significant portion of the time for initial evaluation and treatment of outpatients for emergency medical conditions ." An emergency medical condition (EMC) is defined as "a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs." For example, a pregnant woman with an emergency condition must be treated until delivery is complete unless a transfer under the statute is appropriate.is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA).It requires hospital Emergency Departments that accept payments from Medicare to provide an appropriate medical screening examination (MSE) to individuals seeking treatment for a medical condition, regardless of citizenship, legal status, or ability to pay. Participating hospitals may not transfer or discharge patients needing emergency treatment except with the informed consent or stabilization of the patient or when their condition requires transfer to a hospital better equipped to administer the treatment.Patients treated under EMTALA may not be able to pay or have insurance or other programs pay for the associated costs but are legally responsible for any costs incurred as a result of their care under civil law.

Not all medical conditions qualify for uncompensated mandated services imposed by EMTALA, which is contrary to the misperception that many individuals assume that if they are ill, they will be treated, regardless of their ability to pay.In a meta-analysis of the evidence-based literature, Mac Leod, Di Giacomo, and Tinkoff reviewed 45 articles and noted that from a public safety perspective, helmet use in motorcycle riders reduces overall death rates, the incidence of lethal head injury, and the number of non-lethal head injuries.



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