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Managed Care
August 2000 |
Medicare+Choice pullouts' deep, deep sting The health plan exodus from Medicare+Choice will affect 934,000 people in 2001 -- more than were affected in 1999 and 2000 combined, according to the Health Care Financing Administration.   |
Managed Care
August 2000
Michael Levin-Epstein |
Will Fifth Circuit's Decision Spur Action on Patient Rights? The recent Fifth Circuit Court decision on Texas's statute allowing patients to sue HMOs for denial of physician-recommended care is helping to clarify where state and federal interests in patient rights lie -- and what Congress could do to spell out those interests. |
Managed Care
August 2000
Bob Carlson |
'All Products' Clauses Fade From Physician Contracts All-products provisions in health plan provider contracts are slowly being negotiated, legislated, and regulated out of existence. They are now illegal in at least four states; legislation is pending in several others. |
Managed Care
August 2000
Mark D. Abruzzo, J.D. |
Supreme Court Ruling Encourages Greater Awareness Among Patients To you and me, the court's holding in Pegram means that patients cannot sue HMOs under ERISA for giving doctors financial incentives to hold down costs. However, as is typical with many court decisions, this makes one wonder whether it doesn't take on a much greater meaning. |
Managed Care
May 2000
John Carroll |
Like Stock Brokers, Are Health Care's Middlemen Losing Influence? Those who make deals between buyers and insurers are used to perks and tidy commissions. The Internet and defined contributions may threaten that. |
Managed Care
May 2000 |
Texas-Aetna Incentives Settlement Worries Some Capitated Physicians If the Texas deal ignites a trend away from the use of incentives to keep utilization down, then some capitated physicians worry it will put them in a tight spot. |
Managed Care
May 2000 |
Arizona Nixes Doc Incentives, OKs Plan Liability The publicity given to the Texas attorney general's agreement with Aetna overshadowed a more sweeping edict in Arizona regarding financial incentives to physicians.... |
Managed Care
May 2000 |
Physicians Fudge Insurance Forms To Help Patients A study confirms what has long been considered common but is rarely discussed: Physicians often lie about patients' conditions to gain or improve coverage for their treatment. |
Managed Care
May 2000 |
The latest blow to managed care? The Texas attorney general's decision in the Aetna case is the latest in a long string of events that has gutted the fundamentals of managed care. Many in health care think that some or all of these developments have stripped health plans of their ability to manage care effectively.... |
Managed Care
May 2000 |
Headlines On Deadline... Insurance briefs |
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