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Full-Text Articles in Law
The Supreme Court's Limitation Of Managed-Care Liability, Wendy K. Mariner
The Supreme Court's Limitation Of Managed-Care Liability, Wendy K. Mariner
Faculty Scholarship
This article summarizes and critiques the U.S. Supreme Court's decision in Aetna Health Inc. v. Davila, which limited managed care organizations' liability for negligent decisions about the care of patients in private employer-sponsored health plans governed by ERISA. It contrasts the Court's dichotomous view of health benefit plans, in which insurers administer contracts and treating physicians make medical judgments, with the more complicated relationships that affect decisions about both coverage and treatment.
The Insurance Aspects Of Damages, Robert H. Jerry Ii, Douglas R. Richmond
The Insurance Aspects Of Damages, Robert H. Jerry Ii, Douglas R. Richmond
UF Law Faculty Publications
"[I]t is difficult ... to imagine an event or transaction that does not involve insurance in some way." So it is with the most salient event in the lives of Tony and Donna Sabia, whose son Tony John Sabia, or "Little Tony," was born with profound disabilities. In the final analysis, the ability of Tony and Donna to pay for the future medical care and living expenses needed by their son depends on whether they can reach the liability insurance coverage possessed by the health care providers who attended Donna and Little Tony at the time of his birth. It …
Mainstreaming Complementary And Alternative Medicine In The Face Of Uncertainty, Barbara L. Atwell
Mainstreaming Complementary And Alternative Medicine In The Face Of Uncertainty, Barbara L. Atwell
Elisabeth Haub School of Law Faculty Publications
Part I of this article provides an overview of the medical necessity test, and examines the decision-making process pursuant to the test, including who makes coverage determinations and what criteria are used in making them. Part I also sets forth examples of conventional treatments that insurers routinely cover despite their questionable efficacy from a medical necessity perspective. Part II explores CAM disciplines and describes how they differ from conventional medicine. Part III discusses the legal challenges CAM faces and explores the limited extent to which CAM is covered by health insurance and the failure of state laws to provide mandates …
Images Of Health Insurance In Popular Film: The Dissolving Critique, Elizabeth Pendo
Images Of Health Insurance In Popular Film: The Dissolving Critique, Elizabeth Pendo
All Faculty Scholarship
Several recent films have villainized the health insurance industry as central elements of their plots. This Article examines three of those films: Critical Care, The Rainmaker, and John Q. It analyzes these films through the context of the consumer backlash against managed care that began in the 1990s and shows how these films reflect the consumer sentiment regarding health insurance companies and the cost controlling strategies they employ. In addition, the Article identifies three key premises about health insurance in the films that, although exaggerated and incomplete, have significant factual support. Ultimately, the author argues that, despite their passionately critical …
Images Of Health Insurance In Popular Film: The Dissolving Critique, Elizabeth Pendo
Images Of Health Insurance In Popular Film: The Dissolving Critique, Elizabeth Pendo
Articles
Several recent films have villainized the health insurance industry as central elements of their plots. This Article examines three of those films: Critical Care, The Rainmaker, and John Q. It analyzes these films through the context of the consumer backlash against managed care that began in the 1990s and shows how these films reflect the consumer sentiment regarding health insurance companies and the cost controlling strategies they employ. In addition, the Article identifies three key premises about health insurance in the films that, although exaggerated and incomplete, have significant factual support. Ultimately, the author argues that, despite their passionately critical …