Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds.
THE ME-P DISCLAIMER: Posts, comments and opinions do not necessarily represent iMBA, Inc., but become our property after submission. Copyright © 2006 to-date. iMBA, Inc allows colleges, universities, medical and financial professionals and related clinics, hospitals and non-profit healthcare organizations to distribute our proprietary essays, photos, videos, audios and other documents; etc. However, please review copyright and usage information for each individual asset before submission to us, and/or placement on your publication or web site. Attestation references, citations and/or back-links are required. All other assets are property of the individual copyright holder.
Ask-An-Advisor
QUESTION: A question to ME-P readers and subscribers.
Medicare may disallow private contracting by federal law. But, can private insurances, whether PPO or managed care, legally prevent a patient from privately contracting with their doctor for services or goods above the contracted rates, as long as informed consent and appropriate waivers are executed in advance of the service?
IOWs: Do private managed care insurance companies have the legal right to limit a person’s liberty to seek care above the constraints of the health insurers contract, if the patient so desires? I understand that an insurer by contract with provider and patient is obligated to pay only a negotiated fee for a specific service or good, but if the patient desires a more accommodating service or extra features to a durable good, do they have the right to privately contract for such services beyond the contract payment or benefit restraints. I believe that this goes into state law safeguards for patient welfare in as much as most non-federal or non-ERISA health insurances are guided by state law.
Assessment
This is not a naïve question for I have posed it to various plan medical directors in our area and have had surprisingly varied responses.
I welcome your crowd-sourced comments with thanks in advance.
Dr. Mark D. Dollard
Loudoun Foot and Ankle Center
46440 Benedict Drive
Suite #111 – Sterling, VA 20164
703 444-9555 [ph] 703 444-1190 [fax]
Conclusion
Your thoughts and comments on this ME-P are appreciated; especially from our healthlaw attorney readers, plan subscribers, consultants and medical directors. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos
Our Other Print Books and Related Information Sources:
Health Dictionary Series: http://www.springerpub.com/Search/marcinko
Practice Management: http://www.springerpub.com/product/9780826105752
Physician Financial Planning: http://www.jbpub.com/catalog/0763745790
Medical Risk Management: http://www.jbpub.com/catalog/9780763733421
Hospitals: http://www.crcpress.com/product/isbn/9781439879900
Physician Advisors: www.CertifiedMedicalPlanner.org
Share this:
Filed under: "Ask-an-Advisor", Health Insurance, Health Law & Policy, Practice Management | Tagged: ABN, ERISA, Mark Dollard, May Patients Privately Contract with their Doctors?, medicare | 1 Comment »
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 