High-need users of health care services would be more likely to select a federally qualified HMO
, weakening their economic position.
In 1978 the company began operations as a federally qualified HMO
A community-rated figure for a federally qualified HMO
in Missouri as of March of this year is $147.
In addition, States that allow Medicaid recipients to choose a federally qualified HMO
can elect to require recipients to remain in an HMO for 5 months following an initial 1-month trial period.
Federally qualified HMO
,s, which account for a large majority of HMO participants in both sectors, must provide certain health services that may not be included in traditional fee-forservice plans.
The HMO Act of 1973 (Public LAw 93-222) offered financial support for the development of new HMOs and required employers who offered traditional health insurance plans to also offer an HMO alternative if a federally qualified HMO
was available in the area.
Second, we assume that the products are distinguishable from one another by the fact that coverage under the traditional Medicare program and, therefore, HMO Medicare products, is typically broader than that required for private products produced by federally qualified HMOs
(Zarabozo and LeMasurier ).
Federally qualified HMOs
are allowed to limit benefits under the HMO Act of 1973.
In addition, there were 76 PHPs, 52 Federally qualified HMOs
, and 22 PCCMs.
These plans are not regulated by the Federal HMO Act or by any State HMO mandates and are not required to offer the broad range of services or the community premium ratings mandated for federally qualified HMOs
As of June 1, 1988, 138 plans had signed TEFRA risk contracts with the Health Care Financing Administration (HCFA) as federally qualified HMOs
or competitive medical plans (CMPs).