Making managed care share malpractice risk: bill would remove plans' protection from liability

Article Abstract:

Representative Charlie Norwood and Senator Alfonse D'Amato have sponsored companion bills which would overturn the exemption from state malpractice laws held by employer-sponsored heath plans under the Employee Retirement Income Security Act (ERISA). This will allow patients to bring liability suits against not only their health care providers but also their health plans. The legislation stems from beliefs that ERISA plans have unfair advantages because of protection not extended to other plans. The bills also evolved due to perceptions that managed care plans can contribute to inadequate treatment.

Regulation, Licensing, and Inspection of Miscellaneous Commercial Sectors, Consumer Protection Programs NEC, Hospital and medical service plans, Medical Care Insurance, Consumer protection, Health insurance, Malpractice

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Emergency care standards seen as step forward, but not enough

Article Abstract:

The American Association of Health Plans' (AAHP) new emergency care coverage policy addresses pressing consumer and provider issues, but many health care groups want further policy or legislation to ensure sufficient emergency care coverage. The new AAHP policy asks health plans to cover emergency care for the stabilization of patients with conditions that appear to constitute a medical emergency. Health care groups believe that enforceable legislation is the only way to guarantee better emergency care coverage.

Health Care, Finance, Emergency medical services, American Association of Health Plans

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Opposition to outpatient mastectomy mounts

Article Abstract:

The Department of Health and Human Services has issued a policy letter which prohibits managed care plans contracting with Medicare from requiring that breast cancer surgeries be performed as outpatient procedures. The agency's mastectomy policy came under fire Feb 13, 1997, by Medicare fee-for-service providers. Legislators Rosa L. DeLauro, Alfonse D'Amato and Tom Daschle have sponsored mastectomy bills.

Surgical Procedures, Administration of Public Health Programs, Health Care Services, Analysis, Health care industry, Surgery, Medical policy, Health policy, Medicare, Daschle, Thomas A., Surgery, Outpatient, Ambulatory surgery, D'Amato, Alfonse M., DeLauro, Rosa L.

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