The California Relative Value Studies, an Overview and the California Physicians Service, the Corporation, and Its Relationship with the California Medical Association: A Study
United States. Congress. Senate. Committee on Governmental Affairs. Permanent Subcommittee on Investigations
U.S. Government Printing Office, 1979 - Group medical practice - 275 pages
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accept addition American amount appears applied assigned average basis billed Blue Shield Board California Chairman changes charge data claims codes compares concept concern considered consultant conversion factor cost Council County CRVS Committee customary descriptors determined developed discussed Doctor dollar values established example fee schedule final hospital included increase indicate individual less letter levels limited listed majority median Medical Association Medicare medicine meeting operation opinion orthopedic paid patient payment percent performed physicians Policy practice present problem procedures profession profiles proposed question range reasonable recommendations reflect Relative Value Studies represent requested response result revision San Francisco shows Society specialty specific Standard Subcommittee submitted subsequent suggested surgeons Surgery surgical terminology Total number unit values University usual various visits
Page 22 - Civic leagues or organizations not organized for profit but operated exclusively for the promotion of social welfare...
Page 203 - In determining the reasonable charge for services for purposes of this paragraph, there shall be taken into consideration the customary charges for similar services generally made by the physician or other person furnishing such services, as well as the prevailing charges in the locality for similar services.
Page 25 - Insurance is a contract whereby one undertakes to indemnify another against loss, damage or liability arising from an unknown or contingent event.
Page 22 - Code or of rendering any such services, but it may not engage directly or indirectly in the performance of the corporate purposes or objects unless all of the following requirements are met: (a) At least one-fourth of all licentiates of the particular profession become members.
Page 59 - In holding that certain anticompetitive conduct by lawyers is within the reach of the Sherman Act we intend no diminution of the authority of the State to regulate its professions.
Page 59 - ... they have broad power to establish standards for licensing practitioners and regulating the practice of professions. We also recognize that in some instances the State may decide that 'forms of competition usual in the business world may be demoralizing to the ethical standards of a profession.
Page 21 - Carrying on business at a profit as an incident to the main purposes of the corporation and the distribution of assets to members on dissolution are not forbidden to nonprofit corporations, but no corporation formed or existing under this part shall distribute any gains, profits, or dividends to any of its members as such except upon dissolution or winding up.
Page 203 - Customary is defined as that range of usual fees charged by physicians of similar training and experience for the same service within given specific limited geographic or socio-economic area." "Reasonable is defined as a fee which meets the above two criteria, or, in the opinion of the responsible local medical association's review committee, is justifiable in the special circumstances of the particular case in question.