Legal Issues Associated with Development and Implementation of Provider-sponsored Managed Care Organizations

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Publisher :
ISBN 13 :
Total Pages : 76 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Legal Issues Associated with Development and Implementation of Provider-sponsored Managed Care Organizations by :

Download or read book Legal Issues Associated with Development and Implementation of Provider-sponsored Managed Care Organizations written by and published by . This book was released on 1998 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Strangers in the Night

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Publisher : Oxford University Press
ISBN 13 : 0190288299
Total Pages : 497 pages
Book Rating : 4.1/5 (92 download)

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Book Synopsis Strangers in the Night by : Peter D. Jacobson

Download or read book Strangers in the Night written by Peter D. Jacobson and published by Oxford University Press. This book was released on 2002-08-08 with total page 497 pages. Available in PDF, EPUB and Kindle. Book excerpt: More than ever before, the legal system plays a vital role in virtually every aspect of the current health care system. From the congressional debate over patients' rights legislation to judicial rulings on the denial of health care services, the legal system is integrally involved in the organization, financing, and delivery of health care. This book explains how the legal system helps shape health care delivery and policy, explores new ways of looking at the relationship between law and medicine, and reflects on why it all matters. The story focuses on the judicial response to the advent of managed care, especially challenges to cost containment initiatives, and shows how the legal system has facilitated managed care's dominance over the health care system. An equally important part of the story is the evolution of the relationship between physicians and attorneys and how their mutual antagonism affects patient care. In the end, the stories come together around a strategy for reconciling the difficult health policy choices the country faces and for restoring the physician-patient relationship to the center of health care delivery.

Managed Care

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Publisher :
ISBN 13 :
Total Pages : 268 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Managed Care by : David A. Bennahum

Download or read book Managed Care written by David A. Bennahum and published by . This book was released on 1999 with total page 268 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Managed Care takes a hard, balanced look at the realities of managed health care, assembling the key decision makers in the Albuquerque, New Mexico, health care area - from the CEO of the hospital system to the director of managed care, a home health care specialist, a lawyer, chaplains, and professors at the medical school - to examine the critical issues facing managed care today."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved

Law and Practice of Private Health Insurance and Managed Care

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Publisher : diplom.de
ISBN 13 : 3832423214
Total Pages : 147 pages
Book Rating : 4.8/5 (324 download)

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Book Synopsis Law and Practice of Private Health Insurance and Managed Care by : Christian Funk

Download or read book Law and Practice of Private Health Insurance and Managed Care written by Christian Funk and published by diplom.de. This book was released on 2000-04-28 with total page 147 pages. Available in PDF, EPUB and Kindle. Book excerpt: Inhaltsangabe:Abstract: A true revolution has taken place in the financing of health care in America. Today, managed care is dominating the way Americans receive and pay for their health care. With the rise of managed care medicine has been wrenched out of its atomized world of solo physician practices and community hospitals and has been transformed into a modern industry of giant for-profit companies traded on Wall Street. The current marketplace is characterized by mergers, acquisitions and the establishment of giant multi-billion dollar healthcare networks. Hospitals and managed care plans run big advertisement campaigns in the media, praising their products and services in order to get the biggest share possible of the $1.1 trillion America spends on health care each year. All parties involved in providing health care lobby for their interests at all levels of political decision-making in order to influence legislators and policymakers. Today s health care market changes quickly and at a high rate. New variations of managed care arise constantly making any analysis of managed care an ongoing game of "catch-up" with the marketplace. While writing this paper, for example, UnitedHealthcare dropped one of the major managed care instruments, utilization review, to address public s concerns and pending legislation. This paper will take a snapshot of managed care on the eve of the new millennium by using the most recent information available. After this introduction, the paper will give a description of the current American health care system in chapter two (The U.S. Health Care System). Then, the paper will focus on two aspects: A detailed description of managed care in chapter three (Managed Care) and an introduction of the main issues connected with this way of providing health care in chapter four (Managed Care issues). The paper will argue in chapter five (Results and Future Developments), that managed care of the future will be a light version of what is currently existing, resulting in less strict restrictions and more freedom for patients and doctors. Finally, the report will focus on recent developments in Germany, where policy-makers have started to adopt particular elements of managed care. In chapter six (Managed Care Approaches in Germany), the paper will argue, that Germany should pay more attention to the American experiences regarding managed care in order to prevent harm for patients in [...]

Guide to Key Legal Issues in Managed Care Quality

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Publisher : Faulkner & Gray, Incorporated
ISBN 13 : 9781881393719
Total Pages : 253 pages
Book Rating : 4.3/5 (937 download)

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Book Synopsis Guide to Key Legal Issues in Managed Care Quality by : Alice G. Gosfield

Download or read book Guide to Key Legal Issues in Managed Care Quality written by Alice G. Gosfield and published by Faulkner & Gray, Incorporated. This book was released on 1996-01-01 with total page 253 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Healthcare Law and Ethics

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Publisher :
ISBN 13 :
Total Pages : 342 pages
Book Rating : 4.:/5 (321 download)

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Book Synopsis Healthcare Law and Ethics by : Dean M. Harris

Download or read book Healthcare Law and Ethics written by Dean M. Harris and published by . This book was released on 1999 with total page 342 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Integrating Managed Care and Ethics

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Publisher : McGraw-Hill Professional Publishing
ISBN 13 :
Total Pages : 376 pages
Book Rating : 4.4/5 (91 download)

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Book Synopsis Integrating Managed Care and Ethics by : Dennis A. Robbins

Download or read book Integrating Managed Care and Ethics written by Dennis A. Robbins and published by McGraw-Hill Professional Publishing. This book was released on 1998 with total page 376 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrating Managed Care and Ethics addresses legal and ethical challenges that arise in managed care and includes a discussion of trends, alluding to recent legislative/ regulatory initiatives, major legal cases, and examines guidance offered through several of the major healthcare trade associations. Its goal is to help the reader develop increased talent, tools, and techniques to help transform challenges and change into more positive outcomes.

Managed Care Legal Issues

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Publisher :
ISBN 13 : 9781568290768
Total Pages : 260 pages
Book Rating : 4.2/5 (97 download)

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Book Synopsis Managed Care Legal Issues by : Bruce A. Johnson

Download or read book Managed Care Legal Issues written by Bruce A. Johnson and published by . This book was released on 1996 with total page 260 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Managed Care

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Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834211209
Total Pages : 184 pages
Book Rating : 4.2/5 (112 download)

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Book Synopsis Managed Care by :

Download or read book Managed Care written by and published by Jones & Bartlett Learning. This book was released on 1998 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a result of intense lobbying by consumers and health care providers, managed care organizations are under close scrutiny. More and more frequently, states are taking assertive roles in governing managed care operations, including monitoring how they contract with providers and what types of benefits they provide to enrollees. In this volume, you'll learn how MCOs nationwide are being held accountable to a complex array of new laws -- and what you can expect and demand from MCOs according to new laws.

Managed Care Litigation

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Publisher :
ISBN 13 : 9781570184789
Total Pages : 0 pages
Book Rating : 4.1/5 (847 download)

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Book Synopsis Managed Care Litigation by : Julie A. Barnes

Download or read book Managed Care Litigation written by Julie A. Barnes and published by . This book was released on 2005 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical reference written specifically for practitioners who handle managed care disputes to help them rapidly focus on key issues and expertly advise their clients. Managed Care Litigation offers in-depth analysis of all the important issues in managed care litigation. Providing both a basic overview and a comprehensive examination of the legal issues facing managed care practitioners, Managed Care Litigation gives practical guidance on common managed care disputes; the main features of a typical ERISA lawsuit and ERISA preemption strategies; utilization review and coverage disputes; prompt pay statutes; health plan liability laws, post-Davila; state insurance administrative processes; contractual disputes between payors and providers; managed behavioral health care litigation issues; litigating disputes arising under Medicare, Medicaid, and other federal health programs; antitrust laws and the defenses managed care entities and providers can use; and class action lawsuits.

Managed Care Answer Book

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Publisher :
ISBN 13 :
Total Pages : 1142 pages
Book Rating : 4.4/5 (91 download)

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Book Synopsis Managed Care Answer Book by : Sheryl Tatar Dacso

Download or read book Managed Care Answer Book written by Sheryl Tatar Dacso and published by . This book was released on 1999 with total page 1142 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is an indispensable reference for all professionals involved in the design, implementation, financing, or operation of a managed care program, written in the classic answer book format. You'll find extensive sections providing basic understanding of managed care, cost containment strategies, and advice on organization and implementation of programs. The topic is covered from the ground up, with crucial questions and authoritative, up-to-date answers on every facet of managed care, including such valuable features as: Contract negotiation strategies and dispute resolution techniques Maximizing utilazation review and outcomes assessment Techniques for managed care implementation and administration Plus payer and provider contracting; advice on legal and regulatory considerations; important issues covered from both purchaser's and provider's perspectives; and discussion on information technology and telemedicine.

The Challenge of Regulating Managed Care

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Publisher : University of Michigan Press
ISBN 13 :
Total Pages : 232 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis The Challenge of Regulating Managed Care by : John Eugene Billi

Download or read book The Challenge of Regulating Managed Care written by John Eugene Billi and published by University of Michigan Press. This book was released on 2001-11-08 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: Representatives of industry, government, caregivers, and consumers join scholars and policy analysts in comparing market forces to regulation as potential means for righting what is wrong with managed care. The contributors that John E. Billi and Gail B. Agrawal have gathered here quickly move the healthcare debate beyond the classroom, think tank, and statehouse to the boardroom and examining room. Some argue strongly that the solution is to be found in the democratic process and government intervention, while others maintain that only market forces in a competitive environment can respond quickly to the needs of consumers and purchasers alike. The contributors' diverse opinions about the oversight of managed care reflect an enduring divide, one that will affect how society ultimately resolves questions about the inevitable tradeoffs among health-care quality, cost, and access in an environment of limited resources. The Challenge of Regulating Managed Care will appeal to policymakers, those in the medical field, and all readers interested in the American experience with managed care. John E. Billi is Associate Professor of Internal Medicine and Medical Education; Associate Dean for Clinical Affairs, University of Michigan Medical School; and Associate Vice President for Medical Affairs, University of Michigan. Gail B. Agrawal is Associate Professor of Law, University of North Carolina, Chapel Hill.

Regulating Managed Care

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Publisher : Jossey-Bass
ISBN 13 :
Total Pages : 408 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Regulating Managed Care by : Stuart H. Altman

Download or read book Regulating Managed Care written by Stuart H. Altman and published by Jossey-Bass. This book was released on 1999-06-25 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: What should be government's role in a market-oriented health caresystem? What's the appropriate amount of regulation? Who should regulate-states, federal government, or marketforces? What role do the courts play in this regulation? Are there existing models that might guide leaders in designing aneffective regulatory structure? Welcome to the great managed care debate. In Regulating ManagedCare, twenty-six of the nation's leading health policy experts givehealth care administrators, clinicians, and policy makers insightinto the issues behind this critical exchange and provide leaderswith a road map to assess the policy options available to protectthe quality of our health care delivery system. "This collection of papers, from an extraordinary group of authors,makes a valuable contribution to the ongoing policy debate and willbe of interest to anyone concerned with the future of our healthcare system."---Charles A. Sanders, retired chairman and CEO GlaxoInc. and former general director, Massachusetts General Hospital

The Ethics of Managed Care: Professional Integrity and Patient Rights

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Publisher : Springer Science & Business Media
ISBN 13 : 9401704139
Total Pages : 189 pages
Book Rating : 4.4/5 (17 download)

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Book Synopsis The Ethics of Managed Care: Professional Integrity and Patient Rights by : W.B. Bondeson

Download or read book The Ethics of Managed Care: Professional Integrity and Patient Rights written by W.B. Bondeson and published by Springer Science & Business Media. This book was released on 2013-03-09 with total page 189 pages. Available in PDF, EPUB and Kindle. Book excerpt: This collection provides a philosophical and historical analysis of the development and current situation of managed care. It discusses the relationship between physician professionalism and patient rights to affordable, high quality care. Its special feature is its depth of analysis as the philosophical, social, and economic issues of managed care are developed. It will be of interest to educated readers in their role as patients and to all levels of medical and health care professionals.

Legal Issues Associated With Development and Implementation of Provider-Sponsored Managed Care Organizations

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Publisher :
ISBN 13 : 9780756706241
Total Pages : 65 pages
Book Rating : 4.7/5 (62 download)

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Book Synopsis Legal Issues Associated With Development and Implementation of Provider-Sponsored Managed Care Organizations by : Anne M. Murphy

Download or read book Legal Issues Associated With Development and Implementation of Provider-Sponsored Managed Care Organizations written by Anne M. Murphy and published by . This book was released on 1998-10-01 with total page 65 pages. Available in PDF, EPUB and Kindle. Book excerpt: In an era of change in our Nation's health care delivery system, substance abuse service (SAS) & mental health providers (MHP) must reconfigure their organizational structures & operations to accommodate managed care (MC) methodologies. This report summarizes the legal issues that SAS & MHP must address when organizing provider-sponsored MC org. (MCOs) & when implementing MC programs through contract negotiation & the delivery of services & care through provider contracts. It furnishes SAS providers, MHP, & provider-sponsored network/MCOs with an overview of pertinent legal, structural, & operational considerations.

State by State Guide to Managed Care Law

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Publisher : Aspen Publishers
ISBN 13 : 9780735504905
Total Pages : 368 pages
Book Rating : 4.5/5 (49 download)

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Book Synopsis State by State Guide to Managed Care Law by : Donald R. Levy

Download or read book State by State Guide to Managed Care Law written by Donald R. Levy and published by Aspen Publishers. This book was released on 1999-12-01 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt: Until now, the search for information on managed care was 5 times as difficult as it had to be. Now, you can examine and compare regulatory policies state by state. the State by State Guide to Managed Care Law simplifies and expediates your research by giving you immediate access to key court decisions, state managed care policies and practices, and extensive citations to codes and regulations - for all 50 states. Identify your issue in the index and turn to the page indicated. You'll find current, authoritative information that can help you: Evaluate baseline quality standards, determine when managed care enrollees have access to providers Establish guidelines for collection and disclosure of financial information Arm yourself to tackle the complicated issue of prescription drugs Ensure the managed care organization recognizes patients' and providers' due process rights. Whether you are involved in the design, delivery, or regulation of managed care, you can count on State by State Guide to Managed Care Law for a valuable national snapshot. Managed care is undeniably a permanent part of the health care landscape, so keep this portable and precise reference close at hand for daily consultation.

Managed Health Care

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Publisher :
ISBN 13 :
Total Pages : 428 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis Managed Health Care by :

Download or read book Managed Health Care written by and published by . This book was released on 1986 with total page 428 pages. Available in PDF, EPUB and Kindle. Book excerpt: