Court narrows landmark liability ruling.
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Blue Cross Blue Shield Insurance Plans↗
Biomedical subjects
P M Kazon
Publications and source records attributed to P M Kazon.
Courts debate when coverage ends.
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Health Benefit Plans, Employee↗
AIDS case involving donated blood prompts new privacy concerns.
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Acquired Immunodeficiency Syndrome↗
High court's override on Patrick renews concerns about peer review risk.
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Economic Competition↗
New Hampshire court permits outpatient services without CON.
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Certificate of Need↗
Court overturns jury's verdict on Blue Cross antitrust violation claim.
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Blue Cross Blue Shield Insurance Plans↗
Colorado court rules employer, insurer bias in nonpregnancy coverage.
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Colorado↗
Court decisions give Blues plans one win, one loss in separate antitrust cases.
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Blue Cross Blue Shield Insurance Plans↗
Federal court upholds state ban on balance billing for Medicare.
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Fees, Medical↗
FTC focuses on protecting health care competition in analyzing mergers.
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Economic Competition↗
Legal basis and interpretations of medical necessity.
This article examines the legal issues surrounding medical necessity in Medicare reimbursement. The author reviews how the Health Care Financing Administration has defined medical necessity for laboratory testing and the role of the laboratory and the laboratory manager in ensuring medical necessity.
Centers for Medicare and Medicaid Services, U.S.↗