TITLE

When the HMO says No

AUTHOR(S)
Rice, Berkeley
PUB. DATE
May 2002
SOURCE
Medical Economics;5/10/2002, Vol. 79 Issue 9, p43
SOURCE TYPE
Trade Publication
DOC. TYPE
Article
ABSTRACT
Discusses the impact of the U.S. Supreme Court case Rush Prudential HMO versus Moran on the issue of an Illinois law that calls for an independent review when a health maintenance organization would not pay for treatment recommended by the patient's physician. Overview of the lawsuit filed by Debra Moran against Rush Prudential; Basis of the decision of Rush Prudential in denying Moran a microneurolysis; Right of patients under the Employee Retirement Income Security Act.
ACCESSION #
7127487

 

Related Articles

  • Split standard. Lentz, Rebecca // Modern Physician;Jan2002, Vol. 6 Issue 1, p24 

    Presents information on a case to be heard by the United States Supreme Court on compliance by health plans with external review board laws. Facts of the case Rush Prudential HMO versus Moran; Possible scenarios that will arise from the case.

  • RUSH PRUDENTIAL HMO, INC. v. MORAN et al.: certiorari to the united states court of appeals for the seventh circuit .  // Supreme Court Cases: The Twenty-first Century (2000 - Present);2009, p1 

    The article presents information on U.S. Supreme Court case Rush Prudential HMO Inc. v. Moral et al., case number 00-1021, argued on January 16, 2002 and decided on June 20, 2002. Petitioner denied respondent's request to have surgery by an unaffiliated specialist on the ground that the...

  • U.S. Supreme Court Upholds State HMO Act Requirement for Independent Medical Review of ERISA Plan Claim Denial. Conway, Susan G. // Venulex Legal Summaries;2002 Q3, p1 

    The article reports on the ruling of the U.S. Supreme Court on the case Rush Prudential HMO Inc. versus Moran which concerns on the state medical review requirement for Employee Retirement Income Security Act (ERISA) plan claim. It held that a health maintenance organization (HMO) that contracts...

  • Independent External Review of Health Maintenance Organizations' Medical-Necessity Decisions. Mariner, Wendy K. // New England Journal of Medicine;12/26/2002, Vol. 347 Issue 26, p2178 

    The article discusses the decision administered by the U.S. Supreme Court in the case Rush Prudential HMO, Inc. v. Moran with reference to the federal Employee Retirement Income Security Act (ERISA) of 1974. On June 20, 2002, the court in this case upheld an Illinois state law which necessitates...

  • Texas Law on Independent Review of HMO Denials to be Reconsidered. Pinkall, Jason D. // Venulex Legal Summaries;2002 Q3, p1 

    The article reports that the U.S. Supreme Court has ordered the Fifth Circuit Court of Appeals to review its decision striking down the Texas Insurance Code provisions allowing patients to seek independent review of the medical necessity determinations of health maintenance organizations. The...

  • SUPREME COURT HEARS HMO MEDICAL REVIEW CASE.  // hfm (Healthcare Financial Management);Mar2002, Vol. 56 Issue 3, p22 

    Reports on a hearing by the U.S. Supreme Court of a patients' rights case on January 16, 2002. Background on the Rush Prudential HMO Inc. versus Moran case; Provisions of the Illinois HMO Act; Basis of the decision.

  • Patient Participation in Research in the Managed Care Environment: Key Perceptions of Members in... Purdy, Sarah; Finkelstein, Jonathan A.; Fletcher, Robert; Christiansen, Cindy; Inui, Thomas S. // JGIM: Journal of General Internal Medicine;Jul2000, Vol. 15 Issue 7, p492 

    This study's objective was to elicit the views of research among enrollees in an HMO. A questionnaire was mailed to 207 adult enrollees, 55% had been exposed to research and 45% had not. Ninety-four percent of respondents supported research within the HMO, and 87% thought using information from...

  • Calif. report card finds HMOs just average. Kertesz, Louise // Modern Healthcare;7/01/96, Vol. 26 Issue 27, p2 

    Reports on the release of a report card by the California Cooperative HEDIS Reporting Initiative comparing the HMO performance using data validated by an independent auditor. Performance of the HMO in line with expectations; Number of health plans rated; Three top performers.

  • HMOs take bite out of worker dental costs.  // Indianapolis Business Journal;1/15/96, Vol. 16 Issue 44, p21A 

    Discusses issues relating to dental health maintenance organizations in the United States. Reasons why dental HMOs have not drawn the enrollment that medical HMOs have; Benefits for employees and dentists.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics