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Medical necessity is a legal doctrine in the United States related to activities that may be justified as reasonable, necessary, and/or appropriate based on evidence-based clinical standards of care. In contrast, unnecessary health care lacks such justification. Other countries may have medical doctrines or legal rules covering broadly similar ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Commitment proceedings often follow a period of emergency hospitalization, during which an individual with acute psychiatric symptoms is confined for a relatively short duration (e.g. 72 hours) in a treatment facility for evaluation and stabilization by mental health professionals who may then determine whether further civil commitment is ...
The Baker Act allows for involuntary examination, which can be initiated by an ex-parte order of a judge, law enforcement officials, or certain health professionals. These health professionals include physicians, clinical psychologists, nurses with certain types of training (psychiatric nurse, APRN), clinical social workers, mental health ...
Physician's News Digest article on Certificates of Medical Necessity; Statutory definition of a CMN at the SSA website; Medicare manual that provides exhaustive information about the practical use of CMNs, particularly section 5.3. This is the official source of information for contractors administering the Medicare system about the use of CMNs.
It is meant to protect individuals with mental health disorders on the basis of parens patria. In order to be involuntary hospitalized under the obligatory dangerousness criterion, one must have a mental illness, and most states also require that the individual is in need of medical treatment for the illness.
People looking to save money for a big trip or financial investment may want to make plans around an "extra" paycheck in their pocket.. Employees who get paid on a biweekly basis (every other week ...
The Mental Health Parity Act (MHPA) is legislation signed into United States law on September 26, 1996 that requires annual or lifetime dollar limits on mental health benefits to be no lower than any such dollar limits for medical and surgical benefits offered by a group health plan or health insurance issuer offering coverage in connection with a group health plan. [1]