Managed Care

A list of topics of interest to consumers attempting to get health care benefits from their managed care company or HMO:

The HMO Page HMOs have introduced a novel innovation in American Health care: incentives for physicians not to treat patients. If a medical practitioner practices less, the company makes more. Kind of like paying farmers not to grow crops. HMOs make money by not providing a product. The cost is pain and suffering which won't show up in a balance sheet.

HMOs and managed care companies are governed by both federal and state laws. Federal law, particularly ERISA, have little impact on regulating HMOs.  As a matter of fact, ERISA allows HMOs to avoid liability for their actions, particularly wrongful denials of benefits.

It is a hidden byproduct of the managed care era.

Medicare Rights Center MRC Perspective: Getting Information from Your HMO, January, 1998. Studies show that people on Medicare get most of their information about HMOs from marketing materials that show healthy people smiling and exercising. While good health and exercise are important, people need to be more concerned about how the HMOs treat people with serious health care needs. Getting this important information from HMOs can be difficult, if not impossible.

Managed Care: Empowering Consumers

Shawnee Hills gets six-month license,Patient care, record-keeping problems found Wednesday September 1, 1999 By Dawn Miller

Study Finds Inadequate Monitoring of Pharmacy Benefits for Mental Health by Medicaid Managed Care Programs

Welcome to the Virtual Law Offices of David L. Trueman I am an attorney and a psychologist committed to helping people with their problems.  Our health care system has been compromised by managed care and its desire to make as much money as possible.

 

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