Managed health care: does it offer a cure for the nation's health care ills? : ALI-ABA course of study materials, September 26-27, 1991, Washington, Part 3
American Law Institute-American Bar Association Committee on Continuing Professional Education, 1991 - Business & Economics - 503 pages
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Development of Managed Care Networks of Hospitals
RESPONSIBILITIES OF JV 9
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activities admission Agreement anti anticompetitive antitrust laws applicable appropriate arrangements Blue Cross Blue Shield cert charity claims community benefit competition competitors contract Copayments cost court coverage decision denial denied documents emergency room employees entities ERISA exemption federal fees HCQIA Health Maintenance Organizations Health Plan Health Services HMO's hospital's inpatient involved issues joint ventures JV Members JV Participating Provider JV Provider liability limited litigation managed care plan market power Medicaid Medical Director medical necessity medical staff Medicare merger model HMOs nonprofit hospitals operated organization party patient payment payor PHCS PIPA plaintiff Plan Member policies practice Preferred Provider Organizations Primary Care Physician procedures programs Provider's quality assurance reasonable referral reimbursement relevant market retiree Revenue Revenue Ruling risk rule rule of reason Section Sherman Act staff privileges standards tax-exempt hospitals termination tion trust law utilization review violation