ERISA; for employers participating in 'regional alliances,' pre-emption of state laws would be gone

Article Abstract:

Pres Bill Clinton's health care reform plan would greatly reduce ERISA pre-emption of state laws on employee health benefits, and the possible consequences of this modification have so far not been addressed. Without the ERISA pre-emption shield, state laws could impose costly liabilities on insurers and employers operating through any of the contemplated medical networks. These liabilities could push up the cost of health care reform. Health care networks will not be able to follow through on their cost containment aims unless they are freed from the danger of unlimited malpractice liability.

Exclusive and concurrent legislative powers, Preemption (Legislative power)

---

Outcomes assessment; defining 'medically necessary' and clarifying dispute procedures are key to the plan's success

Article Abstract:

The Clinton administration's health care reform plan proposes to make doctor-insurer disputes over medical care utilization the responsibility of the administrative branch rather than of the medical consumer. The plan also envisions a detailed regulatory scheme which should minimize such disputes. The scheme would be administered by a National Health Board and a National Quality Management Program. There will continue to be disputes, regardless of the administrative superstructure, and the plan needs to clarify what grievance procedures and remedies are to be.

Medical economics

---

Similar abstracts:

• Abstracts: Ethics; existing statutes may not stop health plans from discriminating through selective marketing. Insurance; states have reason to worry about losing authority to regulate insurers

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.