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BlueCross Blue Shield of Minnesota has launched a "shared incentive" payment model with four of Minnesota's largest care systems-Allina Hospitals & Clinics, Essentia Health, Fairview Health Services, and HealthEast Care System. (See, In San Diego, Anthem Blue Cross is collaborating with Sharp Community Medical Group and Sharp Rees-Stealy Medical Centers on an ACO (see http://www. sharp. com/news/anthem-blue-cross-scmg-srs-collaborate. cfm)
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BlueCross Blue Shield of Minnesota has launched a "shared incentive" payment model with four of Minnesota's largest care systems-Allina Hospitals & Clinics, Essentia Health, Fairview Health Services, and HealthEast Care System. (See http://www. bcbs. com/news/plans/minnesota-largest-health-plan-signs-new-total-cost-of-care-contracts. html) In San Diego, Anthem Blue Cross is collaborating with Sharp Community Medical Group and Sharp Rees-Stealy Medical Centers on an ACO (see http://www. sharp. com/news/anthem-blue-cross-scmg-srs-collaborate. cfm).
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Note
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42 U. S. C. § 256a-1 [Under the PPACA section for "Establishing Community Health Teams to Support the Patient-Centered Medical Home" one requirement of health teams is that they "implement interdisciplinary, interprofessional care plans" § 256a-1(c)(4)] and 42 U. S. C. § 1396w-4 [Under PPACA's "State Option to Provide Health Homes for Enrollees with Chronic Conditions", the care team is comprised of "physicians and other professionals, such as a nurse care coordinator, nutritionist, social worker, behavioral health professional, or any professionals deemed appropriate by the State." § 1396w-4(h)(6).].
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42 U. S. C. § 1899(b)(1)(E)
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42 U. S. C. § 1899(b)(1)(E).
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Proposed rule 42 C. F. R. § 425. 4
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Proposed rule 42 C. F. R. § 425. 4.
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Proposed rule 42 C. F. R. § 425. 5(d)(15)(ii)(B)(4)
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Proposed rule 42 C. F. R. § 425. 5(d)(15)(ii)(B)(4).
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Proposed rule 42 C. F. R. § 425. 5(d)(15)(ii)(B)(3)
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Proposed rule 42 C. F. R. § 425. 5(d)(15)(ii)(B)(3).
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29 U. S. C. § 1185a; 29 C. F. R. § 2590. 712
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29 U. S. C. § 1185a; 29 C. F. R. § 2590. 712.
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42 U. S. C. § 13951(c).
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Note
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States with mental health parity statutes are: Alabama (§ 27-54-4(b)), Alaska (§ 21. 54. 151), Arizona (§ 20-2322), Arkansas (§§ 23-99-501 to 23-99-12), Connecticut (§ 38a-476a), Georgia (§ 33-29-24. 1), Hawaii (§ 431 M-5), Idaho (for state employees at § 67-5761A), Illinois (215 § 5/370c), Indiana (§§ 27-13-7-14. 8, 27-8-5-15. 6), Kansas (§ 40-2, 105a), Minnesota (62Q. 47), Missouri (§ 376. 811), Montana (§ 33-22-703), Nebraska (§ 44-793), New Hampshire (§ 415: 18-a), New Mexico (§§ 59A-23E-18), New York (Ins. § 3221(1)(5)(A)), North Carolina (§ 58-3-220), North Dakota (§26. 1-36-08), Ohio (§§ 3923: 29, 3923: 281, 3923: 282), Oklahoma (§ 6060. 11), Oregon (§ 743A. 168), Rhode Island (Ch. 27-38. 2), South Carolina (§ 38-71-290), South Dakota (§ 58-17-98), Tennessee (§ 56-7-2360 [mental health], § 56-7-2602 [substance abuse]), Texas (Ins. § 1355), Vermont (8 § 4089b), Virginia (38. 2 § 3412. 1: 01 [mental health only]), and Wisconsin (§ 632. 89).
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(National Institute of Mental Health Archive, 1998) at 54 (listing states that had enacted mental health parity laws by 1997 as: Arizona, Arkansas, Colorado, Connecticut, Indiana, Maine, Maryland, Minnesota, Missouri, New Hampshire, North Carolina, Rhode Island, South Carolina, Texas and Vermont)
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National Advisory Mental Health Council Parity in Financing Mental Health Services (National Institute of Mental Health Archive, 1998) at 54 (listing states that had enacted mental health parity laws by 1997 as: Arizona, Arkansas, Colorado, Connecticut, Indiana, Maine, Maryland, Minnesota, Missouri, New Hampshire, North Carolina, Rhode Island, South Carolina, Texas and Vermont).
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National Advisory Mental Health Council Parity in Financing Mental Health Services
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Note
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Insurance coverage for the treatment of mental illness is required by Alabama (27-54-4(a)), Arkansas (§ 23-86-113), California (Ins. § 10125), Connecticut (§ 38a-488a), Delaware (Ins. § 3578), Florida (§ 627. 668), Georgia (§ 33-24-28. 1), Hawaii (§ 431 M-4(c)), Illinois (215 § 5/370c), Iowa (§ 514 C. 22), Kansas (§ 40-2, 105), Louisiana (R. S. 22: 1043), Maine (Title 24-A, §§2749, 2843, 4234-A), Massachusetts (Ch. 175, § 47B), Missouri (§§ 376. 814, 376. 1550), Montana (§ 33-22-703), Nevada (§§ 689A. 0455, 689 C. 169), New Hampshire (§ 417-E: 1), New Jersey (§§ 17: 48-6v, 17: 48A-7u, 17: 48E-35. 20, 17B: 26-2. 1 s, 17B: 27-46. 1v), North Carolina (§ 58-3-220), Ohio (§ 3923: 282), Oklahoma (§ 6060. 11), Oregon (§ 743A. 168), Rhode Island (Ch. 27-38. 2), South Carolina (§ 38-71-290), South Dakota (§ 58-17-98), Tennessee (§ 56-7-2601), Texas (Ins. § 1355), Utah (§ 31A-22-625 [mandating offer of coverage]), Vermont (8 § 4089b), Virginia (38. 2 § 3412. 1), Washington (§ 48. 21. 241 [commercial insurance] and § 48. 41. 220 [coverage by state insurance pool]), West Virginia (§ 33-16-3a) Wisconsin (§ 632. 89), and Wyoming (§§ 26-22-102, 26-22-106).
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Note
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Insurance coverage for the treatment of substance abuse is required by Arkansas (§ 23-79-139), Colorado (§ 10-16-104. 7), Delaware (Ins. § 3343(b)), Florida (§ 627. 669), Hawaii (§ 431 M-4(b)), Kansas (§ 40-2, 105), Louisiana (R. S. 22: 1025), Maine (24-A, §2842), Maryland (§ 15-802), Mississippi (§ 83-9-27), Missouri (§ 376. 811), Montana (§ 33-22-703), Nevada (§§ 689A. 046, 689 C. 166), New Jersey (§§ 17: 48-6a, 17: 48A-7a, 17: 48E-34, 17B: 26-2. 1), New Mexico (§§ 59A-23-6; 59A-47-35), North Dakota (§26. 1-36-08), Ohio (§ 3923: 29), Oregon (§ 743A. 168), Tennessee (§ 56-7-2601), Texas (Ins. § 1368), Utah (§ 31A-22-625 [mandating offer of coverage]), Vermont (8 § 4089b), Virginia (38. 2 § 3412. 1), and Wisconsin (§ 632. 89).
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Note
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Insurance coverage of autism spectrum disorders is required in California (Health & Safety Code § 1374. 72), Connecticut (§ 38a-514b), Illinois (215 ILCS 5/3562. 14), Indiana (§ 27-13-7-14. 7), Louisiana (§ 22: 1050), Nevada (§ 689A. 0435), Pennsylvania (40 P. S. § 764 h), South Carolina (§ 38-71-280), Vermont (8 § 4088i), Virginia (38. 2 § 3412. 1: 01), and Wisconsin (§ 632. 895(12 m)).
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42 U. S. C. § 18031(j)
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42 U. S. C. § 18031(j).
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42 U. S. C. § 18022(b)(1)(E)
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42 U. S. C. § 18022(b)(1)(E).
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84866105101
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Affordable Care Act § 1311(j); see also PHS Act § 2726 E, Internal Revenue Code § 9812, (February 2, 2010) and guidance published on June 30, 2010, December 22, 2010 (http://www. dol. gov/ebsa/faqs/faq-aca5. html), and November 17, 2011 (http://www. dol. gov/ebsa/faqs/faq-aca7. html)
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Affordable Care Act § 1311(j); see also PHS Act § 2726 E, Internal Revenue Code § 9812. See also interim final regulations at 75 FR 5410 (February 2, 2010) and guidance published on June 30, 2010 (http://www. dol. gov/ebsa/faqs/faq-mhpaea. html), December 22, 2010 (http://www. dol. gov/ebsa/faqs/faq-aca5. html), and November 17, 2011 (http://www. dol. gov/ebsa/faqs/faq-aca7. html).
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See also interim final regulations at 75 FR 5410
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Department of Health and Human Services. Essential Health Benefits Bulletin, ed2011: 13
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Department of Health and Human Services. Essential Health Benefits Bulletin. In: Oversight CfCIaI, ed2011: 13.
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