MANAGED CARE July 2004. ©MediMedia USA
In a major victory for HMOs, the Supreme Court voted unanimously on June 21 that patients may not sue health plans in state courts for refusing to pay for medical care recommended by physicians. Such lawsuits are barred under the 1974 federal Employee Retirement Income Security Act, the court ruled.... Managed Medicare stands to benefit greatly from reform. A Commonwealth Fund study says that the federal government will pay an average of 8.4 percent more for Medicare enrollees who are in managed care plans than for those who use traditional fee-for-service Medicare under the Medicare Modernization Act that went into effect this year.