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NEDA TOOLKIT for Educators Health Insurance Reform for Consumers  Federal law has provided to consumers some valuable — though limited—protections when obtaining, changing, or continuing health insurance. Understanding these protections, as well as laws in the state in which one resides, can help with making more informed choices when work situations change or when changing health coverage or accessing care. Three important federal laws that can affect coverage and access to care for people with eating disorders are listed below. More information is available at www.cms.hhs.gov • Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) • Health Insurance Portability and Accountability Act of 1996 (HIPAA) • Mental Health Parity Act of 1996 (MHPA) Health Maintenance Organization (HMO)  A health plan that employs or contracts with primary care physicians to write referrals for all care that covered patients obtain from specialists in a network of healthcare providers with whom the HMO contracts. The patient’s choice of treatment providers is usually limited. Hematemesis  The vomiting of blood. Hypnobehavioral Therapy  A type of behavioral therapy that uses a combination of behavioral techniques, such as self-monitoring to change maladaptive eating disorders, and hypnotic techniques intended to reinforce and encourage behavior change. Hypoglycemia  An abnormally low concentration of glucose in the blood. In-network benefits  Health insurance benefits that a beneficiary is entitled to receive from a designated group (network) of healthcare providers. The “network” is established by the health insurer that contracts with certain providers to provide care for beneficiaries within that network. Indemnity Insurance  A health insurance plan that reimburses the member or healthcare provider on a fee-for-service basis, usually at a rate lower than the actual charges for services rendered, and often after a deductible has been satisfied by the insured. Independent Living Services  Services for a person with a medical or mental health-related problem who is living on his/her own. Services include therapeutic group homes, supervised apartment living, monitoring the person’s compliance with prescribed mental and medical treatment plans, and job placement. Intake Screening  An interview conducted by health service providers when a patient is admitted to a hospital or treatment program. International Classification of Diseases (ICD-10)  The World Health Organization lists international standards used to diagnose and classify diseases. The listing is used by the healthcare system so clinicians can assign an ICD code to submit claims to insurers for reimbursement for services for treating various medical and mental health conditions in patients. The code is periodically updated to reflect changes in classifications of disease or to add new disorders. Interpersonal Therapy (IPT)  A type of therapy designed to help people identify and address their interpersonal problems, specifically those involving grief, interpersonal role conflicts, role transitions, and interpersonal deficits. In this therapy, no emphasis is placed directly on modifying eating habits. Instead, the expectation is that the therapy will enable people to change as their interpersonal functioning improves. IPT usually involves 16 to 20 hour-long, one-on-one treatment sessions over a period of four to five months. Ketosis  A condition characterized by an abnormally elevated concentration of ketones in the body tissues and fluids, which can be caused by starvation. It is a complication of diabetes, starvation, and alcoholism. Level of Care  The care setting and intensity of care that a patient is receiving (e.g., inpatient hospital, outpatient hospital, outpatient residential, intensive outpatient, residential). Health plans and insurance companies correlate their payment structures to the level of care being provided and also map a patient’s eligibility for a particular level of care to the patient’s medical/psychological status. Major Depressive Disorder or Major Depression  A condition characterized by one or more major depressive episodes that consist of periods of two or more weeks during which a patient has either a depressed mood or loss of interest or pleasure in nearly all activities. Mallory-Weiss Tear  One or more slit-like tears in the mucosa at the lower end of the esophagus as a result of severe vomiting. Page  | 35