Patients’ Rights Revisited

With coverage decisions by managed care companies potentially skewed by dollars and cents issues, rather than driven solely by medical necessity, 42 states have determined that it is only fair for people to be able to challenge the decisions of their health insurers before an independent third party.

A state’s right to guarantee claimants such an appeal is not preempted by the Employee Retirement Income Security Act, according to a decision by the U.S. Supreme Court in Rush Prudential HMO v. Moran.

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