HEALTH CARE

Health care represents a $14.3 billion industry in Maryland with per-capita spending on health care reaching nearly $2,650 in 1997. The Health Care Access and Cost Commission was established to control hosptial and other health care related costs. The Commission also evaluates the quality of services provided by private Health Maintenance Organizations (HMOs).

Medicare is the federal government's health insurance program for Americans 65-years old or older and for those with certain disabilties.

• County Health Departments
  
• Baltimore City Health Department

Local health departments in each Maryland county and Baltimore City are overseen by the Community and Public Health Administration of the Department of Health and Mental Hygiene. The local health department administers and enforces State, county and municipal health laws, regulations, and programs. Public health programs tailored to community needs provide preventive care; immunizations; health education; drug and alcohol abuse counseling; and rabies and communicable disease prevention. Information about these and all other health-related state programs may be found by contacting local health departments.

The Medical Assistance Program, known as Medicaid, provides health insurance for low-income and needy people. Maryland and the federal government jointly fund Medicaid. The program is overseen in Maryland by the Medical Assistance Program of the Department of Health and Mental Hygiene, and on the federal level by the Health Care Financing Administration. During FY1997, Medicaid covered health care for a monthly average of 468,203 people (9.1% of State's population) with expenditures of $2.6 billion, half funded by the State.

Eligibility for Medicaid is determined by local departments of social services. To apply for Medicaid assistance, Maryland residents visit their county department of social services (Baltimore City residents would go to the city department of social services). There, they are interviewed and submit an application. Generally, those who are either older than age 65, under age 21, disabled, blind, or caring for a child whose parent is unemployed, sick, or deceased are eligible for benefits.

As of June 1997, most of Maryland's 330,000 qualifying Medicaid recipients are required to join one of eight State-regulated Managed Care Organizations. Exceptions are made for those who receive long-term care, certain mentally fragile children, or for the mentally handicapped, among others.

• HealthChoice help lines

HealthChoice is the program that places Medicaid recipients into Managed Care Organizations (MCOs). These organizations provide group insurance that covers medical services at select hospitals and clinics participating in HealthChoice and are responsible for meeting nearly all of the recipients' medical needs, except for mental health services and other specific care. Mental health services are provided by the Specialty Mental Health System, which is administered by the Mental Hygiene Administration.

A variety of major programs are offered through HealthChoice. Local health departments identify and enroll Medicaid recipients with special needs or disabilities (such as diabetes, homelessness, alcoholism, or drug addiction) into appropriate programs. One-on-one assistance is available for those who require it.

Additional State-sponsored services include infant and reproductive care through the Office of Maternal Health and Family Planning, nutritional assistance offered by Women, Infant and Children (WIC) Program, and medical care for children through the Maryland Children's Health Program.

To investigate and mediate disputes, health departments act through the Ombudsmen Program to handle enrollees' complaints. Concerns also may be addressed through the HealthChoice Enrollee Action Line at 1-800-284-4510.

The Rare and Expensive Case Management Program and the Stop Loss Case Management Program focus on patient needs and expenses that are not covered by Managed Care Organizations.

Maryland Department of Health & Mental Hygiene
Maryland at a Glance

Maryland Manual On-Line

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