Download or read book ERISA Preemption Remedies for Denied Or Delayed Health Claims written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 1999 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book ERISA PREEMPTION REMEDIES FOR DENIED OR DELAYED HEALTH CLAIMS HEARING S HRG 105 859 COMMITTEE ON APPROPRIATIONS U S SENATE 1 written by and published by . This book was released on 1999* with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book ERISA Preemption Remedies for Denied Or Delayed Health Claims written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 1999 with total page 47 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book ERISA Preemption Remedies for Denied Or Delayed Health Claims written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 1999 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Unfinished Business written by Katherine Traverse Vukadin and published by . This book was released on 2014 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Affordable Care Act (ACA) grew out of a longstanding desire to bring universal healthcare coverage to Americans. But universal healthcare was not the only goal. Some longed to see ERISA's preemption of state-law remedies softened, so that healthcare claims in ERISA plans could no longer be delayed and denied with impunity. While the ACA now extends coverage to more Americans, ERISA preemption remains unchanged. So, when ERISA healthcare plans -- which insure most Americans -- improperly delay or deny healthcare claims, the plans still risk nothing more than the eventual payment of that claim's value.This article posits that ERISA claims processing and preemption reform is the unfinished business of the ACA -- without it, the consumer remains consistently disadvantaged by both the process and substance of healthcare claims processing. Substantively, the ACA leaves ERISA preemption intact so that plan participants with denied claims must work tirelessly and with exacting attention to detail in order to appeal and eventually win back -- at most -- the value of the denied or delayed claim. Without further changes to the claims process and ultimately, to ERISA preemption, the ACA includes more people in health plans but also leaves them vulnerable to the vagaries of health plan decision-makers. The promise of universal, meaningful healthcare coverage therefore remains incomplete.
Download or read book Delayed and Denied written by Katherine Traverse Vukadin and published by . This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This article advocates a shift in thinking in the enforcement of claims processing regulations. Under the current approach, most non-compliance is excused under the “substantial compliance” doctrine, and even substantial departures from the claims regulations generally result in no substantive remedy. This approach excuses practically all instances of regulatory non-compliance and places the enforcement burden on those least able to shoulder it -- the individuals seeking and paying for medical care. Instead, ERISA's goal of ensuring contracted benefits would be better served if enforcement moved to a presumed-harm approach, akin to the approach used in numerous consumer finance laws. This article argues that the same concerns driving consumer financial protections have even greater force where healthcare is concerned.
Download or read book Erisa Preemption written by Lorraine A. Schmall and published by . This book was released on 2009 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The dissatisfaction with the Court's broad interpretation of the preemption provisions of ERISA, without specifically articulating what remedies existed to replace preempted state remedies, has been often brought to the attention of Congress by those who believed that the Court's construction of the preemption provisions of ERISA, without a recognition of some rights and remedies to take the place of preempted state rights and remedies, went beyond what the Congress intended. But the Supreme Court may never have intended for ERISA to preempt health care claims in most instances, and recently reiterated: "in the field of health care, a subject of traditional state regulation, there is no ERISA preemption without clear manifestation of congressional purpose." Federal and state courts have followed that lead by finding ways for state laws to protect their citizens. Apparently, there is a medical malpractice crisis which is caused by too much malpractice by doctors, too greedy plaintiffs, or unwarranted but uncontrolled insurance premiums. But this paper is concerned with how patients who have suffered from poor or inadequate medical care can seek redress. Health care costs continue to skyrocket, and one of the concomitants of cost containment is the creation of legal hurdles for patients who have been injured by a failure to provide, or negligent provision of, health care. Since most health insurance is tied to employment, ERISA, the federal law that regulates all employee benefit plans, including health insurance, complicates patients' medical malpractice claims. Many federal courts have concluded that if the quality or denial of care is considered part of the administration an employee benefit plan, all state actions may be preempted. If an employee wants to bring a claim against the physician or the managed health care organization, the employee must consider whether the claim will fall under state law, or whether the state cause of action will be preempted by ERISA. Because state law may offer employees greater protections than ERISA, broad federal preemption of state law under ERISA is also a part of the problem for an employee seeking protection against employer discharges and other acts that interfere with her rights to benefits. Rather than wait for Congress to amend a complicated tax and labor statute, plaintiffs can begin to look toward resolution in state common and statutory law.
Download or read book Voluntary Efforts to Expand Health Insurance Coverage written by United States. Congress. Senate. Committee on Labor and Human Resources and published by . This book was released on 1998 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The ERISA Preemption Amendments of 1991 written by United States. Congress. Senate. Committee on Labor and Human Resources. Subcommittee on Labor and published by . This book was released on 1991 with total page 136 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Care Law and Ethics written by Mark A. Hall and published by Aspen Publishing. This book was released on 2024-02-28 with total page 1626 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Care Law and Ethics, Tenth Edition offers a relationship-oriented approach to health law—covering the essentials, as well as cutting-edge and controversial subjects. The book provides thoughtful and teachable coverage of all major aspects of health care law, including medical liability. Current and classic cases build logically from the fundamentals of the patient/provider relationship to the role of government and institutions in health care. The book is adaptable to both survey courses and courses covering portions of the field. New to the Tenth Edition: Length: Trimmed by 20% to enhance teachability New author: Nadia N. Sawicki Thoroughly revised coverage of: Medical liability Reproductive rights and justice Public health law Extensive coverage of issues relating to COVID-19 Supreme Court decisions on abortion and the Affordable Care Act Discussion of emerging topics, such as: Gender reassignment Artificial intelligence Revising “brain death” and the “dead donor” rule for organ transplants Work requirements under Medicaid Medical price transparency Vertical integration and cross-market mergers Benefits for instructors and students: The organization vividly presents the entwined roles of patient, provider, and state in understanding and resolving private and public health care dilemmas Scope includes all major areas of health care law and policy Coverage of classic medical liability topics remains substantial Coverage of all major emerging and conventional issues in bioethics, public health, health care finance and reform, and corporate and regulatory law More streamlined editing facilitates coverage of multiple areas or use in survey courses “The strength of the editors and the evolution of the book over a substantial period has allowed the book to become the best from which I have ever taught.” Roy Spece, University of Arizona
Download or read book Handbook on ERISA Litigation written by James F. Jorden and published by Aspen Publishers Online. This book was released on 2006-12-19 with total page 1151 pages. Available in PDF, EPUB and Kindle. Book excerpt: Handbook on ERISA Litigation cuts through complicated statutory provisions andtells you which ERISA claims are recognized by which courts and how tolitigate them.
Download or read book Principles and Practice of Forensic Psychiatry written by Richard Rosner and published by CRC Press. This book was released on 2017-02-03 with total page 1066 pages. Available in PDF, EPUB and Kindle. Book excerpt: The third edition of this award-winning textbook has been revised and thoroughly updated. Building on the success of the previous editions, it continues to address the history and practice of forensic psychiatry, legal regulation of the practice of psychiatry, forensic evaluation and treatment, psychiatry in relation to civil law, criminal law and family law, as well as correctional forensic psychiatry. New chapters address changes in the assessment and treatment of aggression and violence as well as psychological and neuroimaging assessments.
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.
Download or read book Health Care in Transition written by Mary N. Smyth and published by Nova Publishers. This book was released on 2002 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care is clearly in transition -- but to where? Managed or unmanaged care? HMO's or not? Are insurance companies and hospitals the enemy of health care for their own patients? What about the 40,000,000 uninsured in America? Don't ask the patients, for they have become the ping pong balls in the health care game. This book examines important issues in this ever-growing maze.
Download or read book Health Care Quality written by United States. Congress. Senate. Committee on Labor and Human Resources and published by . This book was released on 1998 with total page 140 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Holding Health Care Accountable written by E. Haavi Morreim and published by Oxford University Press. This book was released on 2001-08-16 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health care in the US and elsewhere has been rocked by economic upheaval. Cost-cuts, care-cuts, and confusion abound. Traditional tort and contract law have not kept pace. Physicians are still expected to deliver the same standard of care -- including costly resources - to everyone, regardless whether it is paid for. Health plans can now face litigation for virtually any unfortunate outcome, even those stemming from society's mandate to keep costs down while improving population health. This book cuts through the chaos and offers a clear, persuasive resolution. Part I explains why new economic realities have rendered prevailing malpractice and contract law largely anachronistic. Part II argues that pointing the legal finger of blame blindly or hastily can hinder good medical care. Instead of "whom do we want to hold liable," we should focus first on "who should be doing what, for the best delivery of health care." When things go wrong, each should be liable only for those aspects of care they could and should have controlled. Once a good division of labor is identified, what kind of liability should be imposed depends on what kind of mistake was made. Failures to exercise adequate expertise (knowledge, skill, care effort) should be addressed as torts, while failures to provide promised resources should be resolved under contract. Part III shows that this approach, though novel, fits remarkably well with basic common law doctrines, and can even enlighten ERISA issues. With extensive documentation from current case law, commentary, and empirical literature, the book will also serve as a comprehensive reference for attorneys, law professors, physicians, administrators, bioethicists, and students.
Download or read book ERISA written by Ilene H. Ferenczy and published by Wolters Kluwer Law & Business. This book was released on 2023 with total page 1236 pages. Available in PDF, EPUB and Kindle. Book excerpt:
