Category: M

The act of March 9, 1945, (15 U.S.C. 1011-15) which declares a general policy that Federal laws which regulate or affect business and commerce are not to be interpreted as affecting the insurance business unless specifically provided for. Also known as the McCarran-Wiler Bill (S. 1508) and Public Law 15. Prior to a Supreme Court…

A Federal program which will limit reimbursement for prescription drugs under the Medicare and Medicaid programs, and Public Health Service projects to the lowest cost at which the drug is generally available. Specifically, the program limits reimbursement for drugs under programs administered by HEW to the lowest of the maximum allowable cost (MAC) of the…

Coverage under insurance for the costs of pregnancy, labor and delivery, and, in some cases, family planning, post-partum care and complications of pregnancy. Health insurance policies take different approaches and apply different conditions to maternity benefits.  

Organized health and social services for mothers (particularly as they need family planning and pregnancy related services), their children, and (rarely) fathers. Mothers and children are often considered particularly vulnerable populations with special health needs; their health to be a matter of high public priority; and particularly benefited by preventive medicine. Therefore such services are…

In Congress, a meeting of a Congressional committee at which the committee itself writes law to recommend to the full Congress, makes decisions on appropriations, or otherwise makes policy. Usually takes place after public hearings on the subject matter.  

The tax rate, or percentage, which is applied on the last increment of income for purposes of computing Federal or other income taxes. For example, in 1974 a single individual with an adjusted gross income of $3,000 would pay Federal income tax of $310 plus 19% of the excess over $2,000 (19% being the marginal…

In health economics, the change in the total cost of producing services which results from a small or unit change in the quantity of services being produced. Marginal cost is the appropriate cost concept to consider when contemplating program expansion or contraction. Economies of scale will result from the expansion of a program when marginal…

Insurance against the risk of suffering financial damage because of malpractice.  

Professional misconduct or lack of ordinary skill in the performance of a professional act. A practitioner is liable for damages or injuries caused by malpractice. Such liability, for some professions like medicine, can be covered by malpractice insurance against the costs of defending suits instituted against the professional and/or any damages assessed by the court,…