House approves last-minute health fraud law overhaul

Article Abstract:

The House attached a sweeping provision at the last minute to the Medicare legislation passed in October 1995 that covers health care fraud. The provision makes health care fraud a federal crime while greatly expanding the powers of the government to prosecute health care fraud, and also provides major increases in penalties. Critics of the measure contend that while the objectives are laudable, the general and vague wording of the provision will cause more problems than it solves for health care providers.

Police Protection, Fraud, Social policy, United States. Congress. House

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Doctor-patient ties torn by market upheaval

Article Abstract:

Doctor-patient relationships are being disrupted by economic factors driving frequent changes in health plans. In a survey of 3,000 working individuals from three cities, 45% responded that they have changed health plans in less than three years, and 48% of participants in health maintenance organizations responded similarly. Industry observers note that the survey indicates that people are generally dissatisfied with the rate of change which is often being forced upon them.

Economic aspects, Physician and patient, Physician-patient relations, Surveys

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Court rulings chip away at managed care's ERISA shield

Article Abstract:

State and federal courts continue to broaden states' authority to regulate employee benefit plans. Thirty-three states enacted laws regulating managed care plans during the 1996 legislative session and state assemblies considered over 1,000 anti-managed care bills. As a result of states' increased authority to regulate employee benefit plans, courts are less likely to follow the tradition of interpreting the federal Employee Retirement Security Act of 1974 to preempt state laws.

Regulation, Licensing, and Inspection of Miscellaneous Commercial Sectors, Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs), Income Security, Health Regulation, Domestic economic assistance, Medical law

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