| Titre : | ERISA litigation and physician autonomy. (2000) |
| Auteurs : | P.D. JACOBSON ; S.D. POMFRET |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 283, n° 7, 2000) |
| Pagination : | 921-926 |
| Langues: | Anglais |
| Mots-clés : | Etats Unis ; Amérique ; Assurance maladie ; Conflit travail ; Médecin ; Politique santé ; Autonomie ; Activité professionnelle ; Evaluation ; Organisme professionnel ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST sp5POR0x. Diffusion soumise à autorisation]. The Employee Retirement Income Security Act (ERISA), enacted in 1974 to regulate pension and health benefit plans, is a complex statute that dominates the managed care environment. Physicians must understand ERISA's role in the relationship between themselves and managed care organizations (MCOs), including how it can influence clinical decision making and physician autonomy. This article describes ERISA's central provisions and how ERISA influences health care delivery in MCOs. We analyze ERISA litigation trends in 4 areas : professional liability, utilization management, state legislative initiatives, and compensation arrangements. This analysis demonstrates how courts have interpreted ERISA to limit physician autonomy and subordinate clinical decision making to MCOs'cost containment decisions. Physicians should support efforts to amend ERISA, thus allowing greater state regulatory oversight of MCOs and permitting courts to hold MCOs accountable for their role in medical decision making. |
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