Managed care companies and the practice of medicine
Goodman, C.; Newcomer, L.; Young, R.; Kanwit, S.; Agrawal, G.; Davenport-Ennis, N.; Monaco, G.A.; Rose, L.J.
Oncology 14(11a): 82-91
2000
ISSN/ISBN: 0890-9091 PMID: 11195423 Document Number: 520068
One of the major issues pertaining to the pending legislation for Patient's Bill of Rights is the potential of liability health care plans, particularly when they decline coverage they consider not medically necessary. We call these contracts "managed health care" plans. But, realistically, when is it managing? When is it medicine? When, if at all, does management undermine medicine? And if it does, should managed care organizations--and their representatives--be held legally liable for medical decisions that go wrong? A panel of seven experts examines these questions from medical, payment, patient, legal, insurance, and governing viewpoints.