What Care Should Be Covered?
Mansheim, Bernard J.
Kennedy Institute of Ethics Journal. 1997 Dec; 7(4): 331-336.
The answer to the question of what health care services should be covered by a managed care plan is straightforward; the plan should cover whatever the consumer is willing to pay for. From the plan's perspective, the consumer is the payer, that is, the employer who negotiates the plan; not the individual patient whose personal preferences and interests may be quite different. Since managed care organizations contract with payers to arrange for health care services within a defined set of benefits, there is a broader question as well: Within the benefits chosen by the payer, what actually is covered? Criteria for determining "medical necessity," which managed care plans frequently use as the basis for coverage, are discussed.
Showing items related by title, author, creator and subject.
Post Mortem Scientific Sampling and the Search for Causes of Death in Intensive Care: What Information Should Be Given and What Consent Should Be Obtained? Rigaud, J P; Quenot, J P; Borel, M; Plu, I; Hervé, C; Moutel, G (2011-03)The search for cause of death is important to improve knowledge and provide answers for the relatives of the deceased. Medical autopsy following unexplained death in hospital is one way to identify cause of death but is ...