Physicians in managed care: A multidimensional analysis of new trends in liability and business risk

Journal of Legal Medicine

Volumn 18, Issue 4, 1997, Pages 443-473

  Richards, Edward P ^a   McLean, Thomas R ^a,b  

^a UNIVERSITY OF MISSOURI KANSAS CITY   (United States)

^b UNIVERSITY OF MISSOURI KANSAS CITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

FORGERY; HEALTH INSURANCE; LAW; MANAGED CARE; MANAGED CARE ORGANIZATION; MEDICAL LIABILITY; MEDICAL PRACTICE; REVIEW;

EID: 0031471610     PISSN: 01947648     EISSN: 1521057X     Source Type: Journal    
DOI: 10.1080/01947649709511045     Document Type: Article

References (48)

1. Snyder. 1996. The False Claims Act Applied to Health Care Institutions:Gearing Up for Corporate Compliance. DePaul Health Care L., 1:1
2. 1997. Recent Developments in Managed Care Liability for Physicians. 37th Annual Meeting, American College of Legal Medicine. Mar.71997.
3. Mars. 1997. The Corporate Practice of Medicine:A Call for Action. Health Matrix, 7:241
4. Chase-Lubitz. 1987. The Corporate Practice of Medicine Doctrine:An Anachronism in the Modern Health Care Industry. Vand. L. Rev., 40:445
5. Co-operative Law Co. 1910. N.E., 92:1516 N.Y.
6. Merchants Protective Corp. P., 209363
7. Co-operative Law Co. N.E., 9216
8. Grand Coulee Dam. Hall. 1996. Hard Times Forged Kaiser. San Fran. Chron., Feb. 12:A7
9. Blomquist. 1984. Health Maintenance Organizations and State DRG Hospital Cost Control Programs:The Need for Federal Preemption. Am. J. L. & Med., 10:1
10. Golub. 1986. The Role of Medicare Reimbursement in Contemporary Hospital Finance. Am. J. L. & Med., 11:501503
11. Francesconi. 1995. ERISA Preemption of “Any Willing Provider” Laws—An Essential Step Toward National Health Care Reform. Wash. U.L.Q., 73:227243–61.
12. Dodd. 1996. The Exclusion of Non-Physician Health-Care Providers from Integrated Delivery Systems:Group Boycott or Legitimate Business Practice?. U. Cinn. L. Rev., 64:983
13. Medicare and Medicaid Programs. 1996. Requirements for Physician Incentive Plans in Prepaid Health Care Organizations. Fed. Reg., 61 Dec. 31:69,034
14. Flamm, Goings, Liu and Wolde-Tsadik. 1994. Elective Repeat Cesarean Delivery Versus Trial of Labour:A Prospective Multicenter Study. Obstet. & Gyn., 83:927
15. Centers for Disease Control and Prevention. 1995. Rates of Cesarean Delivery—United States, 1993. Morb. & Mort. Weekly Rep., 44:303
16. Committee on Practice Patterns, American College of Obstetricians and Gynecologists. 1996. Vaginal Delivery after Previous Cesarean Birth. Int'l J. Gyn. & Obstet., 52:90
17. Shahaian, Williamson, Svensson, Restuccia and D'Agostino. 1996. Application of Statistical Quality Control to Cardiac Surgery. Annals Thor. Surg., 62:1351
18. Besdine. 1996. Managed Care and Older Americans:Opportunity and Risk (Progress in Geriatrics:A Clinical Care Update). Generations, 64 Dec.:3
19. Nauert. 1996. Quest for Value in Health Care. J. Heath Care Fin., 22:52
20. Blum. 1996. The Evolution of Physician Credentialling into Managed Care Selective Contracting. Am. J. L. & Med., 22:173189–92.
21. Baker. 1996. Elderly, Poor in HMO's Have Worse Outcomes. Family Prac. News, Nov. 1:20
22. Zoler. 1996. Managed Care:AIDS Patients Appear to Die Sooner. Family Prac. News, Nov. 1:21
23. Ware, Bayliss, Rogers, Kosinski and Tarlov. 1996. Differences in 4-Year Health Outcomes for Elderly and Poor, Chronically Ill Patients Treated in HMO and Fee-for-Service Systems:Results from the Medical Outcome Study. J.A.M.A., 276:1039
24. Yelin, Criswell and Feigenbaum. 1996. Health Care Utilization and Outcome Among Persons with Rheumatoid Arthritis in Fee-for-Service and Prepaid Group Practice Setting. J.A.M.A., 276:1048
25. Gardner. 1996. Higher Medicare Spending Doesn't Guarantee Better Care. Mod. Health Care, Feb. 5:16
26. Richards, Deters and Gray. 1989. Physicians and Their Profession:Do Racketeering Rules Apply?. Nat'l L.J., Aug. 28:38
27. 1986. Cal. Rptr., 228:661 Cal. App.
28. 1990. Cal. Rptr., 271:876 Cat. App.
29. Wilson. Cal. Rptr., 271883
30. Woodhandler and Himmelstein. 1995. Extreme Risk—The New Corporate Proposition for Physicians. New Eng. J. Med., 333:1706
31. 1996. Fed. Reg., 61 Mar. 27:13,446
32. 1996. Fed. Reg., 61 Sept. 3:46,385
33. 1996. Fed. Reg., 61 Dec. 31:69,049
34. Johnson. 1996. HMO Market Drop Could Land on Physicians. Am. Med. News, July 29:1
35. Muirhead. 1996. One Independent's Outcry Finally Gets Results, Drug Topics. Feb. 5:57
36. Berg. 1993. HMO Exclusion of Chiropractors. S. Cal. L. Rev., 66:807837
37. Macey and Miller. 1993. The McCarran-Ferguson Act of 1945:Recon-ceiving the Federal Role of Insurance. N.Y.U. L. Rev., 68:13
38. Slomski. 1991. Washington Turns Up Antitrust Heat on Doctors. Med. Econ., 68 Aug. 15:42
39. Daniels. 1996. Minimizing Physicians’ Exposure to Managed Care Liabilities. Healthcare Fin. Mgmt., 50:84
40. McIlrath and Mitka. 1996. Putting the Brakes on Physician Supply. Am. Med. News, Feb. 12:1
41. Levitsky. 1996. Reimbursement for Cardiac Procedures:Past, Present, and Future. Annals Thor. Surg., 62(5 Supp.):S14–7. S31–2.
42. 1997. A Blow for Maintaining Patient-Physician Relationships in the Era of Managed Care. Notre Dame L. Rev., 72:799
43. Berg. 1992. Judicial Enforcement of Covenants Not to Compete Between Physicians:Protecting Doctors’ Interests at Patients’ Expense. Rutgers L. Rev., 45:1
44. Weems. 1994. Covenants Not to Compete:Recent Missouri Decisions. J. Mo. Bar, 50:169
45. Ward. 1996. Estimation of Capitation Expense for Specialty Services. Annals Thor. Surg., 62(5 Supp.):S26–30. 29
46. Howard. 1995. The Aftermath of HMO Insolvency:Considerations for Providers. Annals Health L., 4:8789
47. Professor, University of Missouri at Kansas City School of Law. Address correspondence to Professor Richards at University of Missouri at Kansas City School of Law, 5100 Rockhill Road, Kansas City, Missouri 64110; via e-mail at erichards@pop.umkc.edu; or on the internet at http://plague.law.umkc.edu.
48. Clinical Associate Professor of Surgery, University of Missouri at Kansas City School of Medicine. Dr. McLean is also a second-year law student in the Flex program at the University of Missouri at Kansas City School of Law.