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Article: Health plan liability in the age of managed care.(Health Care and the Law)
- Article from:
- Defense Counsel Journal
- Article date:
- April 1, 1995
- Author:
CopyrightCOPYRIGHT 1995 International Association of Defense Counsels. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)
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AS THE landscape of health care has been transformed from one dominated by fee-for-service providers and indemnity insurers to one in which "managed care" is rapidly achieving hegemony, a litigation earthquake has been building. Cost containment mechanisms commonly employed by managed care plans--pre-authorization requirements, second surgical opinions, length-of-stay limitations, choice of provider restrictions, capitation and other provider risk-sharing mechanisms--insinuate managed care plans in medical decisions in ways unknown under traditional indemnity health insurance. Because these mechanisms may affect directly the medical care received by patients covered by ...