Independent medical review: expanding legal remedies to achieve managed care accountability.
Author Leatrice Berman-Sandler reports on independent medical review (IMR), a state-based statutory remedy used to resolve disputes over coverage between patients and their health plans. Ms. Berman-Sandler explores the connection between ERISA preemption and IMR, and opines that in light of recent Supreme Court decisions, the stage has been set for expansion of IMR. Accordingly, Ms. Berman-Sandler concludes that there are strong legal and policy reasons for state legislatures to broaden the application of IMR and for the Court to continue to narrow ERISA preemption in order to increase accountability in the managed care arena.
Leatrice
L
Berman-Sandler
D019461:Employee Retirement Income Security Act / Q000331:legislation & jurisprudence; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics* / Q000331:legislation & jurisprudence; D006801:Humans; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence*; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence*; D020380:Needs Assessment; D028701:Patient Rights / Q000331:legislation & jurisprudence*; D011366:Professional Review Organizations; D012941:Social Responsibility; D013219:State Government; D014481:United States