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Antitrust And The Health Care Industry: The View From The Three Branches, Thomas L. Greaney
Antitrust And The Health Care Industry: The View From The Three Branches, Thomas L. Greaney
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This article provides a critical appraisal of the summer's three major health care antitrust events. The California Dental Association case, the Justice Department's challenge to the Aetna-Prudential merger, and the proposed Quality Health Care Coalition Act of 1999 are likely to have a significant influence on the trajectory of antitrust enforcement in the coming years. The author argues that the reasoning of these precedents suffers from an over reaction to the managed care bogeyman and a lack of attention to sound antitrust jurisprudence. In a postscript, it finds similar shortcomings with the Eighth Circuit's recent decision in FTC & State …
Managed Care And Mental Health: Clinical Perspectives And Legal Realities, Jesse Goldner
Managed Care And Mental Health: Clinical Perspectives And Legal Realities, Jesse Goldner
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Managed care is beginning to dominate the delivery of mental health services. The Article reviews limitations on managed care's ability to deal adequately with mental illness. It discusses empirical and other research examining the use of primary care providers as gatekeepers and it explores utilization review mechanisms, focusing particularly on providers' responses to UR. The impact on quality, access and continuity of care on discrete populations is analyzed. The article then surveys a variety of legal issues in the regulation of managed care, particularly as they apply to the provision of mental health services. These include ERISA, parity and liability …
Unnecessary Adversaries At The End Of Life: Mediating End-Of-Life Treatment Disputes To Prevent Erosion Of Physician-Patient Relationships, Robert Gatter
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Professor Gatter estimates that institutional ethics consultation processes are used to resolve as many as 13,500 end-of-life treatment (EOLT) disputes each year. Despite this sizable case load, the law has largely ignored the method of dispute resolution used to address EOLT disagreements. This article argues that, at the stage when an ethics consultation is requested in an EOLT dispute, mediation is the most appropriate method for attempting to resolve that dispute. This article challenges current wisdom that mediation is inappropriate for addressing disputes between physicians and patients. The challenge is based on four key points. First, EOLT disputes between physicians …