 |
|
 |
|
 |
|
 |
|
 |
|
 |
Publications
Published Hospital Peer Review Guides
By clicking on any of the above guides you will be redirected to
National Peer Review Corporation.
“PPOs Must Strengthen Vulnerabilities,” Business Insurance (June 14, 1999)
“Utilization Management Appeals and Liability,” Health Care Innovations (May/June, 1999)
“Poor Public Relations and Liability,” Health Care Innovations (March/April, 1999)
Editor’s Notes regarding AAPPO, Health Care Innovations (May/June, July/August, September/October, 1998 issues)
“AAPPO PPO Contract Summit,” Health Care Innovations (January/February, 1998)
“Trends in Provider Termination from Managed Care Plans,” Health Care Innovations (July/August, 1997)
“Due Diligence of Provider Sponsored Organizations (PSOs),” Health Care Innovations (May/June, 1997)
“Silent
Contracts and Silent PPOs,” Health Care Innovations (March/April, 1997)
“Stacking
of PPOs: Potential Liability for
Payors,” Health Care Innovations (January/February, 1997)
“Reaffirming
Core Managed Care Values,” Health Care Innovations (November/December,
1996)
“An
Approach to the Selection and Termination of Providers in Managed Care
Organizations,” Health Care Innovations (September/October, 1996)
“Non-Negotiable
Contracts,” Health Care Innovations (July/August, 1996)
“Using
Uncredentialed Network Providers,” Health Care Innovations (May/June,
1996)
“Gag
Clauses as a Symptom of the Controversy About Who Controls Medical Care,” Health
Care Innovations (March/April, 1996)
“Request
for Information on PPO Contracting Practices (or Alleged Silent PPO
Practices),” Health Care Innovations (January/February, 1996) (In
conjunction with American Association of Preferred Provider Organizations,
American Medical Association and American Accreditation HealthCare Commission/URAC)
“Due
Diligence for Silent PPO Practices,” Health Care Innovations
(November/December, 1995)
“Silent
PPOs Are Not PPOs,” Health Care Innovations (September/October, 1995)
“PPOs:
Key Part of the Medicare Solution,” Health Care Innovations
(July/August, 1995)
“Due
Diligence in the Delegation of Credentialing,” Health Care Innovations
(May/June, 1995)
“Potential
Danger in Managed Care Contracting,” Health Care Innovations
(March/April, 1995)
“Who’s
Giving Managed Care a Bad Name?”, Journal of AAPPO (November/December,
1994)
“In
Opposition to Any Willing Provider Laws,” Journal of AAPPO (May/June,
1994)
“The
Hillary Effect is Actually Effective Managed Care,” Journal of AAPPO
(March/April, 1994)
“Managed
Care Credentialing: A Consumer Protection,” Journal of AAPPO
(January/February, 1994)
“PPO
Perspective of Managed Care,” Managed Care and Aging (Spring, 1994)
“Physician
Liability and Formularies,” Managed Care Medicine (January/February,
1994)
“Utilization
Management: The Heart of Managed Care,” Journal of AAPPO
(August/September, 1993)
“Finally:
The Recognition of PPOs as Viable Managed Care Programs,” Journal of
AAPPO (June/July, 1993)
“A
View of Health Care Reform,” Journal of AAPPO (April/May, 1993)
“The
Misperception of Managed Care PPOs by Pharmaceutical Companies,” Journal of
AAPPO (February/March, 1993)
“Managed
Care Safe Harbors: The AAPPO Comments to the Office of the Inspector General,”
Journal of AAPPO (February/March, 1993)
“Managed
Care Liability for Utilization Management:
Corcoran v. United Healthcare, Inc.,” Journal of AAPPO
(October/November, 1992)
“Supercredentialing
of Specialty Physician Advisors,” Journal of AAPPO, Editor’s Note
(August/September, 1992)
Chapter 7:
“Legal Structure and Operation,” PPO Evaluation Manual
(American Accreditation Program, Inc., 1992)
“Credentialing
is a Fiduciary Obligation: A Matter of Economics,” Journal of AAPPO (June/July,
1992)
“Inhibitions
to a Long-Term Solution to the Health Care [Cost] Crisis,” Journal of AAPPO,
Editor’s Note (April/May, 1992)
“Business
Coalitions Competing with Managed Care,” Journal of AAPPO, Editor’s
Note (February/March, 1992)
“The
Criteria for Selecting a Managed Care Entity,” Journal of AAPPO,
Editor’s Note (December, 1991/January, 1992)
“Integrating
a Pharmacy Benefit Program into a Managed Healthcare Plan,” American
Association of Preferred Provider Organizations Contributing Committee Member
and Contributing Editor (1991)
“Liability
Relating to Formularies and Drug Utilization Management,” Journal of AAPPO
(April/May, 1991)
“An
Overview of PPO Physician Credentialing,” Journal of AAPPO
(February/March, 1991)
“Utilization
Management Companies: What Every
Clinic Manager Should Know,” Group Practice Journal (1991)
Chapter:
“Preferred Provider and Other Managed Care Agreements:
Contracting Issues,” Hospital Contracts Manual (Aspen
Publications, 1990-Updated 1991)
“Liability
Issues for Managed Care Entities,” 14 Seton Hall Legislative Journal
(1990)
Chapter
22: “Liability Issues for Managed Care Entities,” Medical and Hospital
Negligence, Callaghan & Co. (Fall 1988; Revised, Fall 1989)
Chapter
1: “Preferred Provider
Organizations: Strategies for
Sponsors and Network Providers,” The New Generation of Preferred Provider
Organizations (American Hospital Association, 1989)
Chapter
11: “Liability Issues and
Responses,” The New Generation of Preferred Provider Organizations
(American Hospital Association, 1989)
“Disputing
Claims of ‘Malpractice Minefield’,” Managed Health Care (November 6,
1989)
“The
Direction of the Healthcare Marketplace,” Quality Assurance and Utilization
Review (August, 1989)
“The
Trend is Toward Managed-Care PPOs,” Commerce (January, 1989)
“Negotiating
Healthcare Contracts,” Corporate Health (November/December, 1988)
“Managed
Care PPOs: The Direction of the
Healthcare Marketplace,” Healthcare Executive (September/October, 1988)
“Interview
with Douglas L. Elden, Esq., Chairman of the Board of the American
Association of Preferred Provider Organizations,” HMO/PPO Trends
(September, 1988)
“The
Law & Managed Care: Outside
Peer Review is One Solution to the Patrick Dilemma,” Contract Healthcare
(July, 1988)
“Legislative
Outlook: Will the Medicare PPO
Affect Your PPO?” Corporate Health (May‑June, 1988)
“Liability
Issues For Managed Care Systems,” Managed Care Outlook (January 8,
1988)
“Employer-Sponsored
PPOs to Improve Quality of System,” Business Insurance (November 2,
1987)
Chapter 2:
“The Legal Context and Corporate Liability,” A Guidebook to
Clinical Risk Management (InterQual, Incorporated, 1987, 1990)
“Legal
Issues in Networking with Alternative Delivery Systems,” Journal of
Ambulatory Care Management (Vol. 10, No. 2, May, 1987)
“Legal
Issues in Creating PPOs,” Journal of Law & Health (1985)
“Legal
Issues in Creating PPOs,” The New Healthcare Market:
A Guide to PPOs for Purchasers, Payors and Providers, (Dow
Jones-Irwin, 1985)
Chapter 7:
“Legal Issues,” and Chapter 8: “Structuring
a Cooperative Venture PPO,” Preferred Provider Organizations:
A Seminar on How to Organize, Market and Operate a PPO (InterQual,
Incorporated, 1984)