Patients' Rights After Health Care Reform: Who Decides What is Medically Necessary?
Document Type
Article
Publication Date
9-1994
ISSN
1541-0048
Publisher
American Public Health Association
Language
en-US
Abstract
President Clinton's Health Security Act entitles individuals not to unlimited health care, but to a package of defined insurance benefits with specific exclusions and limitations. Like virtually all reform proposals, it would limit covered benefits to services that are medically necessary. If health reform is to control costs, not all medically necessary care can be covered. In the absence of a generally accepted definition of medical necessity, many services will not be guaranteed to all patients unless they are explicitly covered in the federal legislation or regulations. Without a federal definition of medical necessity or regulations listing covered services, health insurance plans will retain the primary authority to decide what is medically necessary for their patient subscribers.
Recommended Citation
Wendy K. Mariner,
Patients' Rights After Health Care Reform: Who Decides What is Medically Necessary?
,
in
84
American Journal of Public Health
1515
(1994).
Available at:
https://doi.org/https://doi.org/10.2105/AJPH.84.9.1515
