Literature DB >> 23113832

Medicare's enduring struggle to define "reasonable and necessary" care.

Peter J Neumann1, James D Chambers.   

Abstract

Medicare legislation mandates that the program not pay for items and services that are not "reasonable and necessary" - terms that are open to interpretation and easily politicized. In today's fiscal environment, "reasonable and necessary" warrants a closer look.

Mesh:

Year:  2012        PMID: 23113832     DOI: 10.1056/NEJMp1208386

Source DB:  PubMed          Journal:  N Engl J Med        ISSN: 0028-4793            Impact factor:   91.245


  13 in total

1.  There is a mismatch between the medicare benefit package and the preferences of patients with cancer and their caregivers.

Authors:  Donald H Taylor; Marion Danis; S Yousuf Zafar; Lynn J Howie; Gregory P Samsa; Steven P Wolf; Amy P Abernethy
Journal:  J Clin Oncol       Date:  2014-08-25       Impact factor: 44.544

2.  Preparing for success with comparative effectiveness research.

Authors:  Thomas G Roberts
Journal:  Oncologist       Date:  2013-06

3.  Do changes in drug coverage policy point to an increased role for cost-effectiveness analysis in the USA?

Authors:  James D Chambers
Journal:  Pharmacoeconomics       Date:  2014-08       Impact factor: 4.981

4.  Cost-effectiveness data: Are neurologists in practice equipped to interpret them?

Authors:  Saty Satya-Murti
Journal:  Neurol Clin Pract       Date:  2013-10

5.  Insurance coverage for genomic tests.

Authors:  Kathryn A Phillips; Julia R Trosman; Patricia A Deverka; Bruce Quinn; Sean Tunis; Peter J Neumann; James D Chambers; Louis P Garrison; Michael P Douglas; Christine B Weldon
Journal:  Science       Date:  2018-04-19       Impact factor: 47.728

6.  Coverage Denials: Government And Private Insurer Policies For Medical Necessity In Medicare.

Authors:  Aaron L Schwartz; Yujun Chen; Chris L Jagmin; Dorothea J Verbrugge; Troyen A Brennan; Peter W Groeneveld; Joseph P Newhouse
Journal:  Health Aff (Millwood)       Date:  2022-01       Impact factor: 9.048

7.  Quality and cost improvement of healthcare via complementary measurement and diagnosis of patient general health outcome using electronic health record data: research rationale and design.

Authors:  Rodolfo J Stusser; Richard A Dickey
Journal:  J Med Syst       Date:  2013-09-18       Impact factor: 4.460

8.  Value-based drug pricing in the Biden era: Opportunities and prospects.

Authors:  Peter J Neumann; Daniel A Ollendorf; Joshua T Cohen
Journal:  Health Serv Res       Date:  2021-06-03       Impact factor: 3.734

9.  Toward a sociology of finitude: life, death, and the question of limits.

Authors:  Roi Livne
Journal:  Theory Soc       Date:  2021-05-15

10.  The economic value of personalized medicine tests: what we know and what we need to know.

Authors:  Kathryn A Phillips; Julie Ann Sakowski; Julia Trosman; Michael P Douglas; Su-Ying Liang; Peter Neumann
Journal:  Genet Med       Date:  2013-10-17       Impact factor: 8.822

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