Boost for antitrust relief: Marshfield case pushes feds to reconcile guidelines, ruling

Article Abstract:

The Wisconsin Marshfield Clinic and its Health Maintenance Organization has been cleared of any infringement on antitrust laws after the US Supreme Court refused to overturn the judgement made by a federal appeals court. Wisconsin's HMO was accused of dominating the market, but the courts decided that the size of a large network does not indicate its market strength. The challenge will come when this decision is compared to the federal antitrust guidelines, which seem to contradict what the courts have decided.

Health Maintenance Organizations, HMO Medical Centers, Management, Antitrust law, Marshfield Clinic

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Battle over device coverage moves to courts

Article Abstract:

The Health Care Financing Administration (HCFA) will reverse its policy regarding coverage for medical devices as of Nov 1, 1995. The agency in 1994 stopped paying for experimental and investigational devices not yet approved for marketing. However, such devices will again be paid for under Medicare. Several clinical trials involving such devices moved overseas.

Medical Instruments and Supplies, Medical Instruments & Equipment, Medical Equipment and Supplies Manufacturing, Administration of Public Health Programs, Health Care Services, Laws, regulations and rules, Finance, Medical care, Social policy, Medical equipment, Medicare, United States. Centers for Medicare and Medicaid Services

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Supreme Court tackles ERISA - again

Article Abstract:

The Supreme Court has agreed to review a federal appeals court decision on the issue of jurisdiction for provider networks under the Employee Retirement Income Security Act of 1974. The ruling could have significant effects on the emerging health care delivery system as self-funded plans account for up to 65% of the commercial health insurance market.

Public Finance Activities, Direct Health and Medical Insurance Carriers, Public Finance-State, Health Plan Administration, Health insurance industry, State finance, Self-insurance, Self insurance, Medical partnership

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