Fiduciary responsibility and potential liabilities in health care cost management.
This article addresses the key legal issues facing ERISA welfare plan fiduciaries in health care cost management and explores the current status of a number of fiduciary obligations particularly relevant to welfare plan trustees. The authors discuss the fiduciary issues raised by the selection of a health care delivery system, plan design decision making and provider discount arrangements with health plans, and provide suggestion for administering reimbursements for health care costs from third party recoveries and addressing provider fraud.
Fitzgerald
T F
TF
Groom and Nordberg, Washington, DC, USA.
Montez
A C
AC
Edgar
M A
MA
D054598:Blue Cross Blue Shield Insurance Plans / Q000331:legislation & jurisprudence; D003363:Cost Control / Q000331:legislation & jurisprudence / Q000458:organization & administration; D003669:Deductibles and Coinsurance; D019461:Employee Retirement Income Security Act / Q000331:legislation & jurisprudence*; D005376:Financial Management / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000191:economics / Q000331:legislation & jurisprudence*; D016365:Liability, Legal; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence; D012941:Social Responsibility; D014341:Trustees; D014481:United States