title: Medicare's enduring struggle to define "reasonable and necessary" care.
abstract: Medicare legislation mandates that the program not pay for items and services that are not "reasonable and necessary" - terms that are open to interpretation and easily politicized. In today's fiscal environment, "reasonable and necessary" warrants a closer look.
authors.affiliation: Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Neumann
authors.forename: James D
authors.initials: JD
authors.lastname: Chambers
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D003362:Cost-Benefit Analysis; D004608:Eligibility Determination; D019317:Evidence-Based Medicine; D033161:Government Regulation; D015276:Health Care Rationing; D006291:Health Policy; D006801:Humans; D007342:Insurance Benefits / Q000331:legislation & jurisprudence; D006278:Medicare / Q000331:legislation & jurisprudence; D014481:United States