Applying fiduciary responsibilities in the managed care context.

Ethical and legal implications of managed care.

This article addresses several ethical, regulatory, and legal issues in managed care with attention to recent court cases that focus on physicians' responsibility, fiduciary duty, and the impact that these legal decisions have on physicians practicing in a managed care environment. Discussion of the impact of changes in the control of decision-making processes for physicians, the use of managed...

Boards of directors under fire: an examination of nonprofit board duties in the health care environment.

Attorney Ono presents a detailed discussion of fiduciary duty principles as applied to the directors of nonprofit health care corporations in the current health care environment. The article reviews general corporate responsibilities, the implication of the taxpayer's Bill of Rights 2, the care of In re Caremark International Inc. Derivative Litigation and particular issues faced by boards in n...

Is ethics for sale?... Juggling law and ethics in managed care.

INTRODUCTION The need for fundamental changes within the healthcare arena has long been recognized and accepted. However, the debate as to the role that managed care should play in determining patient treatment and the interplay between ethics, law and the managed care of patients, remains the subject of persistent and intense debate. Corporate business practices, including cost-containment, ar...

Pegram's significance for managed health care.

On June 12, 2000, in a unanimous opinion written by Justice Souter, the U.S. Supreme Court, reversing a decision of the U.S. Court of Appeals for the Seventh Circuit, held in Pegram v. Herdrich that “mixed eligibility” decisions made by HMO physicians are not fiduciary decisions under ERISA. In so ruling, the Court upheld the concept that the reasonable sharing of financial risk with HMO networ...

Litigating around ERISA to quality managed healthcare: an HMO can breach fiduciary duties.