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Full-Text Articles in Insurance Law
Medicare's Prospective Payment System At Age Eight: Mature Success Or Midlife Crisis?, Bruce C. Vladeck
Medicare's Prospective Payment System At Age Eight: Mature Success Or Midlife Crisis?, Bruce C. Vladeck
Seattle University Law Review
This Article is necessarily a rather selective (for reasons of brevity and reader tolerance) and even subjective attempt to summarize the experience under PPS to date and to suggest some lessons that might be drawn from that experience for the future reform of PPS itself and of payment systems generally. No attempt will be made here to be comprehensive, to explain all the technical details of an inherently and increasingly complex system, nor even to systematically survey the rapidly growing body of literature. But the few issues and themes that clearly stand out will be the focus of most of …
Private Utilization Review, Marvis J. Oehm
Private Utilization Review, Marvis J. Oehm
Seattle University Law Review
This Article describes the history of private UR and provides illustrations of successes, problems and controversies. The Article concludes with some suggestions and prescriptive advice for those who are likely to encounter UR, either through work with particular clients or directly as part of a private benefit plan.