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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 ...
The survey was paid for by the Oklahoma State Medical Association. Another 84% believe that there should be a limit on health insurance companies requiring prior authorization, he said.
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.
Medical Necessity: Health Care Access and the Politics of Decision Making by Daniel Skinner, a book published by the University of Minnesota Press (2019). Charles Martin, "Medical Use of Cannabis in Australia: 'Medical necessity' defences under current Australian law and avenues for reform" (2014) 21(4) Journal of Law and Medicine 875.
In September 2012, the Los Angeles County Medical Association and two patients sued Health Net for denying medically necessary treatment, including cancer care. [26] The lawsuit alleged that Health Net denied claims based on its own definition of "medical necessity" rather than standards set forth by California law. [ 26 ]
St. Bernards Medical Center is a 454-bed acute-care hospital in Jonesboro, Arkansas. [1] The hospital, established on July 5, 1900, is the flagship facility of its nonprofit parent, St. Bernards Healthcare, serving as a regional referral center for 23 counties in northeast Arkansas and southeast Missouri . [ 2 ]
Texas’ largest outbreak of measles in 30 years has reached 90 cases, the Texas Department of State Health Services said Friday. Thirty-two cases have been added since the department’s update ...
Area codes 870 and 327 are telephone area codes in the North American Numbering Plan (NANP) for southern, eastern, and most of northern Arkansas. 870 was created on April 14, 1997, in a split from area code 501, Arkansas's original area code of 1947, and 327 was added as part of an overlay complex in 2024.