In fiduciaries we trust: court ruling may require HMOs to tell patients about financial incentives designed to curb referrals
Article Abstract:
A landmark court case involving a health maintenance organization's (HMO's) responsibility to disclose financial incentives for discouraging referrals may change this practice for medical and other covered health professions. The United States Court of Appeals found that Patrick Shea's HMO had a duty to disclose this information. Mr. Shea's primary doctor had indicated that a heart specialist referral was not needed. Mr. Shea's HMO frequently offered incentives to its doctors to minimize specialist referrals. Mr. Shea later died of heart failure.
Publication Name: Journal of the American Dental Association
Subject: Health
ISSN: 0002-8177
Year: 1997
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Patient rights, provider rights: balancing the conflict
Article Abstract:
Recent cases filed against dentists and other health care providers by HIV-infected persons have determined these persons to be legally disabled, and therefore can not be denied medical care. The courts held that health professionals could insure their own safety with proper precautions. In Abbott vs. Bragdon, this included an asymptomatic HIV-positive woman. It is also possible that a person may be defined as disabled for no criteria other than that a dentist refused treatment, perceiving the person to be disabled.
Publication Name: Journal of the American Dental Association
Subject: Health
ISSN: 0002-8177
Year: 1997
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ERISA pre-emption at issue: Supreme Court may examine whether state boards can review plan medical directors' treatment decisions
Article Abstract:
The US Supreme Court has been asked to consider a case where a state supreme court ruled that a state medical board could review the decisions of the medical director of an insurance company. Often, these state reviews are pre-empted by the federal Employee Retirement Income Security Act (ERISA).
Publication Name: Journal of the American Dental Association
Subject: Health
ISSN: 0002-8177
Year: 2001
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